Provider Demographics
NPI:1588862874
Name:AHMAD, MOHAMMAD FARHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:FARHAN
Last Name:AHMAD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 TOPEKA DRIVE
Mailing Address - Street 2:
Mailing Address - City:MISSISSAUGA
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L5M 7V1
Mailing Address - Country:CA
Mailing Address - Phone:905-816-0595
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-545-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program