Provider Demographics
NPI:1568821999
Name:DR. FARZAD T PARSI DDS PC
Entity Type:Organization
Organization Name:DR. FARZAD T PARSI DDS PC
Other - Org Name:MAIN STREET DENTISTRY AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZAD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PARSI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-686-6221
Mailing Address - Street 1:251 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5629
Mailing Address - Country:US
Mailing Address - Phone:781-396-6900
Mailing Address - Fax:
Practice Address - Street 1:251 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5629
Practice Address - Country:US
Practice Address - Phone:781-396-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN21006261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental