Provider Demographics
NPI:1952593824
Name:MINHAS, FARAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARAH
Middle Name:
Last Name:MINHAS
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 1:7815 E JEFFERSON AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-3704
Mailing Address - Country:US
Mailing Address - Phone:313-499-4775
Mailing Address - Fax:
Practice Address - Street 1:7815 E JEFFERSON AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3704
Practice Address - Country:US
Practice Address - Phone:313-499-4775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist