Provider Demographics
NPI:1700412384
Name:HUMZAVIS DENTAL
Entity Type:Organization
Organization Name:HUMZAVIS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAZHER
Authorized Official - Middle Name:H
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-227-8277
Mailing Address - Street 1:9327 SKOKIE BLVD UNIT C
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1310
Mailing Address - Country:US
Mailing Address - Phone:847-227-8277
Mailing Address - Fax:847-410-2348
Practice Address - Street 1:9327 SKOKIE BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1310
Practice Address - Country:US
Practice Address - Phone:847-227-8277
Practice Address - Fax:847-410-2348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental