Provider Demographics
NPI:1609160498
Name:RAAD, VERA FARHOUD (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:FARHOUD
Last Name:RAAD
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 1:2611 WILLOWGLEN DR
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-3622
Mailing Address - Country:US
Mailing Address - Phone:626-357-3091
Mailing Address - Fax:626-335-7911
Practice Address - Street 1:130 W ROUTE 66
Practice Address - Street 2:SUITE 316
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6249
Practice Address - Country:US
Practice Address - Phone:626-335-7727
Practice Address - Fax:626-335-7911
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43652122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist