Asim Mohammad Ansari, D.D.S. Valid NPI

Individual provider · Dentist · Glen Ellyn, IL

NPI

1881904670

Type

Individual (Type 1)

Primary specialty

Dentist

Specialty group

Dental Providers

Taxonomy code

122300000X

License number

019028486 (IL)

Sex

Male

Sole proprietor

Yes

Enumerated

2010-10-14

Last updated

2015-12-10