Provider Demographics
NPI:1578684585
Name:M FAROOQ AHMAD INC
Entity Type:Organization
Organization Name:M FAROOQ AHMAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:M.
Authorized Official - Middle Name:FAROOQ
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MBA
Authorized Official - Phone:951-506-6872
Mailing Address - Street 1:31205 PAUBA RD
Mailing Address - Street 2:#205
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:951-506-6872
Mailing Address - Fax:951-506-4712
Practice Address - Street 1:31205 PAUBA RD
Practice Address - Street 2:#205
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-506-6872
Practice Address - Fax:951-506-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0450801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty