Provider Demographics
NPI:1659593036
Name:ABIR FARAJ DDS PC
Entity Type:Organization
Organization Name:ABIR FARAJ DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ABIR
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-348-5151
Mailing Address - Street 1:23975 NOVI RD
Mailing Address - Street 2:STE A102
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2459
Mailing Address - Country:US
Mailing Address - Phone:248-348-5151
Mailing Address - Fax:248-348-5195
Practice Address - Street 1:23985 NOVI RD
Practice Address - Street 2:STE B103
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5436
Practice Address - Country:US
Practice Address - Phone:248-348-5151
Practice Address - Fax:248-348-5195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010190021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty