Provider Demographics
NPI:1083749253
Name:AFTAB, JAMEEL AHMAD (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMEEL
Middle Name:AHMAD
Last Name:AFTAB
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-1814
Mailing Address - Country:US
Mailing Address - Phone:810-653-1500
Mailing Address - Fax:
Practice Address - Street 1:6162 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:ROXBOROUGH
Practice Address - State:PA
Practice Address - Zip Code:19128
Practice Address - Country:US
Practice Address - Phone:215-483-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037002122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist