Provider Demographics
NPI:1487794590
Name:FAROOQ, NAILA S (BDS, MS,DDPH)
Entity type:Individual
Prefix:DR
First Name:NAILA
Middle Name:S
Last Name:FAROOQ
Suffix:
Gender:F
Credentials:BDS, MS,DDPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 UNION LAKE RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4547
Mailing Address - Country:US
Mailing Address - Phone:248-360-2555
Mailing Address - Fax:248-360-1333
Practice Address - Street 1:3101 UNION LAKE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-4547
Practice Address - Country:US
Practice Address - Phone:248-360-2555
Practice Address - Fax:248-360-1333
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010177941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry