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General NPI Number Information
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NPI Number | 1417084336
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Entity Type | Organization
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Legal Business Name | FARRIS AND MOLL PC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 942 MAIN STREET
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City | RED HILL
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State | PA
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Zip | 18076-1339
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Country | US
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Telephone | 215-679-8033
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Fax | 215-679-8038
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Provider Business Mailing Address
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Address Line | 942 MAIN STREET
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City | RED HILL
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State | PA
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Zip | 18076-1339
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Country | US
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Telephone | 215-679-8033
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Fax | 215-679-8038
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. BETTY ANN DIPHILLIPPO
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Credential |
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Telephone | 215-679-4566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DSO16621
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License Number State | PA
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