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General NPI Number Information
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NPI Number | 1427755693
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Entity Type | Individual
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Provider Name | MEHAK GUL HAQ DDS
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Gender | Female
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 7310 WALTON ST
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City | ROCKFORD
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State | IL
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Zip | 61108-4614
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Country | US
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Telephone | 815-395-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 6583 WHISPERING WOODS DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-5201
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Country | US
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Telephone | 248-978-4358
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901601611
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.034104
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License Number State | IL
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