Provider Demographics
NPI:1659064384
Name:HARBA, FARAH (DDS)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:HARBA
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 1:3420 NIXON RD UNIT 215
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2453
Mailing Address - Country:US
Mailing Address - Phone:865-236-2054
Mailing Address - Fax:
Practice Address - Street 1:29627 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2366
Practice Address - Country:US
Practice Address - Phone:734-422-2890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23144070500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist