Provider Demographics
NPI:1972795532
Name:GANJOOR, FERESHTEH (DDS)
Entity Type:Individual
Prefix:
First Name:FERESHTEH
Middle Name:
Last Name:GANJOOR
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 1:3248 S PRESTON RD
Mailing Address - Street 2:# 140
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-3808
Mailing Address - Country:US
Mailing Address - Phone:972-809-7850
Mailing Address - Fax:
Practice Address - Street 1:2750 PRESTON RD
Practice Address - Street 2:STE #111
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009
Practice Address - Country:US
Practice Address - Phone:972-809-7850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23268122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist