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General NPI Number Information
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NPI Number | 1427851252
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Entity Type | Organization
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Legal Business Name | MOHAMMAD TAREQ KHADRA DDS, PLLC
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 2675 S ABILENE ST STE 135
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City | AURORA
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State | CO
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Zip | 80014-2363
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Country | US
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Telephone | 303-751-6916
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Fax |
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Provider Business Mailing Address
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Address Line | 2675 S ABILENE ST STE 135
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City | AURORA
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State | CO
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Zip | 80014-2363
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Country | US
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Telephone | 303-751-6916
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MOHAMMAD TAREQ KHADRA
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Credential |
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Telephone | 401-225-2455
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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 |
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License Number State |
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