Healthcare Provider Details
I. General information
NPI: 1972420149
Provider Name (Legal Business Name): FARRIS FAMILY DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
220 ALABAMA ST
COLUMBUS MS
39702-5204
US
IV. Provider business mailing address
220 ALABAMA ST
COLUMBUS MS
39702-5204
US
V. Phone/Fax
- Phone: 662-328-5197
- Fax: 662-327-5174
- Phone: 662-328-5197
- Fax: 662-327-5174
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
C. CHANCE
FARRIS
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 601-325-8242