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General NPI Number Information
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NPI Number | 1912243106
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Entity Type | Organization
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Legal Business Name | ANTHONY L FARROW
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Dates
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Enumeration Date | 12/17/2012
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 1601 WALNUT STREET SUITE 1601
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City | PHILADELPHIA
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State | PA
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Zip | 19102
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Country | US
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Telephone | 215-569-9060
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 WALNUT STREET SUITE 1601
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City | PHILADELPHIA
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State | PA
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Zip | 19102
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Country | US
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Telephone | 215-569-9060
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY FARROW
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Credential | DMD
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Telephone | 215-569-9060
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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 | DS0242
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License Number State | PA
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