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General NPI Number Information
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NPI Number | 1396408670
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Entity Type | Individual
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Provider Name | SAMANTHA EVANS FARR DDS
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Gender | Female
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 2960 FM 1460 STE 105
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City | GEORGETOWN
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State | TX
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Zip | 78626-3273
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Country | US
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Telephone | 512-316-0777
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Fax | 512-316-0789
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Provider Business Mailing Address
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Address Line | 205 BLUE AGAVE LN
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City | GEORGETOWN
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State | TX
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Zip | 78626-2325
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Country | US
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Telephone | 832-723-7151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 37933
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License Number State | TX
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