Individual
FARASHTA SEDIQZAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-1702
Mailing address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-1702
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
00201953
CO
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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