Provider Demographics
NPI:1275624421
Name:SARFRAZ, TARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:SARFRAZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MCCHESNEY AVE EXT
Mailing Address - Street 2:APT #26-5
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8838
Mailing Address - Country:US
Mailing Address - Phone:716-462-3333
Mailing Address - Fax:
Practice Address - Street 1:404 MCCHESNEY AVE EXT
Practice Address - Street 2:APT #26-5
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-8838
Practice Address - Country:US
Practice Address - Phone:716-462-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052949122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist