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General NPI Number Information
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NPI Number | 1790350544
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD FARRELL DMD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 11/12/2023
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Provider Practice Location Address
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Address Line | 801 N CONGRESS AVE STE 185C
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3364
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Country | US
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Telephone | 561-369-7199
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Fax |
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Provider Business Mailing Address
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Address Line | 728 NE 20TH LN
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-2422
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Country | US
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Telephone | 570-280-9142
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28434
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License Number State | FL
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