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General NPI Number Information
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NPI Number | 1295728822
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Entity Type | Organization
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Legal Business Name | DAVID A. FARLOW, DDS, PC
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 204 WHIPPLE ST
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City | SOUTH LYON
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State | MI
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Zip | 48178-1114
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Country | US
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Telephone | 248-437-6200
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Fax | 248-437-2766
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Provider Business Mailing Address
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Address Line | 204 WHIPPLE ST
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City | SOUTH LYON
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State | MI
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Zip | 48178-1114
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Country | US
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Telephone | 248-437-6200
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Fax | 248-437-2766
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID A. FARLOW
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Credential | D.D.S.
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Telephone | 248-437-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 013141
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License Number State | MI
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