Dr. Mir Ma Khan, D.D.S
Dentist in Wilkes Barre, PA. Individual provider (NPI-1).
NPI number1336346196
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1336346196
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mir Ma Khan
- Credential
- D.D.S
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 27, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 052574-1 | NY | Yes |
Practice location
1111 E End BlvdVamc Medical Center Dental Service
Wilkes Barre, PA 18711-0030
Phone 570-824-3521 · Fax 570-819-5153
Mailing address
620 Country Club AptsRoute 309 N
Dallas, PA 18612-8925
Phone 215-431-2000
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