Provider Demographics
NPI:1497221642
Name:FATEMA, AFRIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:AFRIN
Middle Name:
Last Name:FATEMA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 S WATTERS RD APT 294
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5275
Mailing Address - Country:US
Mailing Address - Phone:817-851-3816
Mailing Address - Fax:
Practice Address - Street 1:5110 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2970
Practice Address - Country:US
Practice Address - Phone:972-377-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist