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General NPI Number Information
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NPI Number | 1568691178
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Entity Type | Individual
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Provider Name | FARAH I KHAN DDS
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Gender | Female
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 105 MYRTLE AVENUE
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City | NEW BRITAIN
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State | CT
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Zip | 06051
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Country | US
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Telephone | 860-356-4033
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Fax |
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Provider Business Mailing Address
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Address Line | 82 BRITTANY FARMS RD APT 231
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City | NEW BRITAIN
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State | CT
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Zip | 06053-1246
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Country | US
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Telephone | 516-232-7609
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 010078
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License Number State | CT
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