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General NPI Number Information
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NPI Number | 1972912327
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Entity Type | Organization
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Legal Business Name | FARR DENTAL
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 1507 LYONS RD.
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City | COCONUT CREEK
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State | FL
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Zip | 33063
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Country | US
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Telephone | 954-974-4101
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Fax | 954-974-4101
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Provider Business Mailing Address
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Address Line | 1507 LYONS RD.
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City | COCONUT CREEK
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State | FL
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Zip | 33063
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Country | US
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Telephone | 954-974-4101
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Fax | 954-974-6154
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Authorized Official
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Title or Position | DR.
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Name | DR. MITCHELL J. FARR
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Credential | D.M.D.
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Telephone | 954-974-4101
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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 | DN10716
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN11255
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License Number State |
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