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NPI Code Detail

MEDICARE: DR. THOMAS LOUIS FARAGO DDS

MEDICARE: DR. THOMAS LOUIS FARAGO DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1680MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568676864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS LOUIS FARAGO DDS
Provider Business Mailing Address
First Line : 1547 S HIGGINS AVE
Second Line :
City : MISSOULA
State : MT
Zip : 59801-4226
Country : US
Telephone Number : 406-549-6081
Fax Number : 406-549-6081
Provider Business Practice Location Address
First Line : 1547 S HIGGINS AVE
Second Line :
City : MISSOULA
State : MT
Zip : 59801-4226
Country : US
Telephone Number : 406-549-6081
Fax Number : 406-549-6081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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