MEDICARE: RHETT FARMER DMD

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
1	1223G0001X	General Practice Dentistry	DGD.9945	SC

General Provider Information

NPI Number	:	1942878830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHETT FARMER DMD

Provider Business Mailing Address
First Line	:	208 PARK DR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-1536
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 BEN CASEY DR STE 139
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8557
Country	:	US
Telephone Number	:	803-547-5002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2021
Last Update Date	:	06/16/2021

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