Individual
AYESHA FAROOQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
14 MACDAVE BLVD, GENTLE DENTAL, COLLINGDALE, PA 19023
(513) 593-0190
Mailing address
324 MEADOWBROOK DR, HUNTINGDON VALLEY, PA 19006-6809
(513) 593-0190
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS039345
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/17/2012
Last updated
12/27/2012
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