US Army
NPI #1407205065 in Lackland Afb, Texas
Provider Information
- NPI Number
- 1407205065
- Entity Type
- Organization
- Organization Name
- US Army
- Primary Specialty
- Point of Service
- Enumeration Date
- Jun 5, 2016
- Last Updated
- Jun 5, 2016
Practice Location
- Address
- 1320 TRUEMPER ST UNIT 369401
- Address 2
- JBSA LACKLAND AFB
- City
- Lackland Afb
- State
- Texas
- ZIP Code
- 78236-6094
- Phone
- (502) 409-2981
Authorized Official
- Name
- DR. FARZAN L POURANFAR, DMD
- Title
- GENERAL DENTIST
- Phone
- (502) 409-2981
Specialties & Taxonomy Codes
| Specialty |
|---|
| Point of Service |
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