MEDICARE: DR. C. CHANCE FARRIS 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	4448-24	MS

General Provider Information

NPI Number	:	1982447868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. C. CHANCE FARRIS DMD

Provider Business Mailing Address
First Line	:	626 S MONTGOMERY ST APT 22
Second Line	:
City	:	STARKVILLE
State	:	MS
Zip	:	39759-3843
Country	:	US
Telephone Number	:	601-325-8242
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 ALABAMA ST
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-5204
Country	:	US
Telephone Number	:	662-328-5197
Fax Number	:	662-327-5174

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

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	02/02/2026

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