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General NPI Number Information
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NPI Number | 1851923734
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Entity Type | Organization
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Legal Business Name | AL MUFTI INC
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Dates
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Enumeration Date | 02/07/2020
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 4343 W ARMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60639-3521
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Country | US
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Telephone | 773-235-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 521 LAVERGNE AVE
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City | WILMETTE
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State | IL
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Zip | 60091-2023
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. FAHAD AL MUFTI
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Credential | DMD
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Telephone | 619-201-7326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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