Organization
US ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARZAN L POURANFAR DMD (GENERAL DENTIST)
(502) 409-2981
Entity
Organization
Contact information
Practice address
1320 TRUEMPER ST UNIT 369401, JBSA LACKLAND AFB, LACKLAND AFB, TX 78236-6094
(502) 409-2981
Mailing address
1320 TRUEMPER ST UNIT 369401, JBSA LACKLAND AFB, LACKLAND AFB, TX 78236-6094
(502) 409-2981
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
9175
KY
Other
Enumeration date
06/05/2016
Last updated
06/05/2016
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