Provider Demographics
NPI:1750613220
Name:ASGHER, KHURRAM (DDS)
Entity type:Individual
Prefix:DR
First Name:KHURRAM
Middle Name:
Last Name:ASGHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 FOREST ST
Mailing Address - Street 2:APT 18
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-2127
Mailing Address - Country:US
Mailing Address - Phone:732-763-6952
Mailing Address - Fax:
Practice Address - Street 1:170 FOREST ST
Practice Address - Street 2:APT 18
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-2127
Practice Address - Country:US
Practice Address - Phone:732-763-6952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist