Healthcare Provider Details

I. General information

NPI: 1073445086
Provider Name (Legal Business Name): MAEGHAN FARLEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 1ST ST N
MONTGOMERY MN
56069-1514
US

IV. Provider business mailing address

110 1ST ST N
MONTGOMERY MN
56069-1514
US

V. Phone/Fax

Practice location:
  • Phone: 507-364-8001
  • Fax:
Mailing address:
  • Phone: 507-364-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD15430
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: