Provider Demographics
NPI:1275848012
Name:HIRAM CENTER FOR FAMILY DENTISTRY
Entity Type:Organization
Organization Name:HIRAM CENTER FOR FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:FARAHANINIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-723-8396
Mailing Address - Street 1:4374 ATLANTA HWY STE 109
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-1849
Mailing Address - Country:US
Mailing Address - Phone:770-505-9898
Mailing Address - Fax:404-393-1154
Practice Address - Street 1:4374 ATLANTA HWY STE 109
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-1849
Practice Address - Country:US
Practice Address - Phone:770-505-9898
Practice Address - Fax:404-393-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013474122300000X
GADN013699122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty