Organization
PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FARAH KHAN DDS,PC (PEDIATRIC DENTIST)
(736) 254-0786
Entity
Organization
Contact information
Practice address
45535 HANFORD RD, CANTON, MI 48187-4595
(734) 254-0786
(734) 254-0861
Mailing address
45535 HANFORD RD, CANTON, MI 48187-4595
(734) 254-0786
(734) 254-0861
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548369291
NATIONAL PROVIDER ID
MI
Enumeration date
06/17/2019
Last updated
06/17/2019
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