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General NPI Number Information
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NPI Number | 1891887568
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Entity Type | Individual
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Provider Name | KENNETH FARRIS FARHA DDS
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 2640 BELL RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-4375
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Country | US
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Telephone | 334-260-0501
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Fax | 334-260-0502
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Provider Business Mailing Address
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Address Line | 2640 BELL RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-4375
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Country | US
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Telephone | 334-260-0501
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Fax | 334-260-0502
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 3754
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License Number State | AL
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