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General NPI Number Information
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NPI Number | 1447715222
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Entity Type | Individual
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Provider Name | PASIL AHMED MADANY DDS
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Gender | Male
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 1004 N GILBERT ST
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City | DANVILLE
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State | IL
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Zip | 61832-3849
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Country | US
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Telephone | 217-442-4267
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 N GILBERT ST
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City | DANVILLE
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State | IL
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Zip | 61832-3849
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Country | US
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Telephone | 217-442-4267
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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 | 019.032758
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.025641
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License Number State | OH
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