Provider Demographics
NPI:1588030795
Name:AJMAL, TOOBA BINT-E- (DDS)
Entity Type:Individual
Prefix:
First Name:TOOBA
Middle Name:BINT-E-
Last Name:AJMAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15750 S BELL RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-8420
Mailing Address - Country:US
Mailing Address - Phone:630-677-1386
Mailing Address - Fax:
Practice Address - Street 1:15750 S BELL RD
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-8412
Practice Address - Country:US
Practice Address - Phone:708-301-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030425122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist