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NPI Code Detail

MEDICARE: DR. FARZANA POYAN DDS

MEDICARE: DR. FARZANA POYAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12010648AIN

General Provider Information

NPI Number : 1720140759
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FARZANA POYAN DDS
Provider Business Mailing Address
First Line : 4200 S EAST ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-1534
Country : US
Telephone Number : 317-787-1320
Fax Number :
Provider Business Practice Location Address
First Line : 4200 S EAST ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-1534
Country : US
Telephone Number : 317-787-1320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 07/29/2010

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Directions to “ DR. FARZANA POYAN DDS” Practice Location

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