Provider Demographics
NPI:1235111972
Name:FARHAT, FOUAD N (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:FOUAD
Middle Name:N
Last Name:FARHAT
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15515 3RD AVE SW STE D
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2553
Mailing Address - Country:US
Mailing Address - Phone:206-244-1410
Mailing Address - Fax:206-244-9127
Practice Address - Street 1:15515 3RD AVE SW STE D
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2553
Practice Address - Country:US
Practice Address - Phone:206-244-1410
Practice Address - Fax:206-244-9127
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000087541223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics