Dr. Taha Mirza, DDS
Dentist, General Practice in Rockford, IL. Individual provider (NPI-1).
NPI number1982198354
StatusActive
Last updated in NPPESJun 19, 2018
Details
- NPI
- 1982198354
- Entity type
- Individual (NPI-1)
- Name
- Dr. Taha Mirza
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 19, 2018
- Last updated
- Jun 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019031740 | IL | Yes |
Practice location
845 S Perryville RdRockford, IL 61108-4340
Phone 779-423-2135
Mailing address
2105 W Silverleaf CtAddison, IL 60101-6403
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