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General NPI Number Information
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NPI Number | 1912836974
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Entity Type | Individual
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Provider Name | MILAN NICO KHAZANA DMD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 1 BELMONT AVE STE 516
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1608
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Country | US
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Telephone | 484-278-4134
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Fax |
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Provider Business Mailing Address
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Address Line | 356 REDBUD LN
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-1584
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Country | US
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Telephone | 610-563-7174
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS045673
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License Number State | PA
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