Individual
FARIDA BHANU NOORBASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
614 W 29TH ST STE 106, SAN ANGELO, TX 76903-2981
(602) 472-1318
Mailing address
7101 APPALOOSA TRL APT 117, SAN ANGELO, TX 76901-5279
(602) 472-1318
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
35379
TX
Other
Enumeration date
06/23/2019
Last updated
06/23/2019
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