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General NPI Number Information
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NPI Number | 1972740991
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Entity Type | Organization
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Legal Business Name | ASIM AWAN DDS PC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2812 HASSERT BLVD STE 104
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City | NAPERVILLE
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State | IL
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Zip | 60564-5826
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Country | US
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Telephone | 312-480-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 4670 GREEN BRIDGE LN
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City | HANOVER PARK
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State | IL
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Zip | 60133-2930
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Country | US
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Telephone | 312-480-8720
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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. ASIM AWAN
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Credential | DDS
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Telephone | 312-480-8720
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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 | 019027437
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License Number State | IL
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