Individual
DR. HESHAM ALI FARAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
233 POMFRET ST, PUTNAM, CT 06260-1835
(860) 928-5334
Mailing address
81 WESTDIND ROAD, APT 68, DORCHESTER, MA 02125
(434) 203-9923
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2013272
CT
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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