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Individual

DR. FEREYDOUN KHALILI I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
103-43 LEFFERTS BLVD., 2ND FL., SOUTH RICHMOND HILL, NY 11419
(718) 843-5500
(718) 841-7600
Mailing address
103-43 LEFFERTS BLVD., 2ND FL., SOUTH RICHMOND HILL, NY 11419
(718) 843-5500
(718) 841-7600

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046106
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01644504
NY
Enumeration date
04/24/2007
Last updated
05/14/2012
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