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Individual
DR. MARK STEVEN FARRIS
Active
Individual
DR. MARK STEVEN FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
NC5490
NC
1223G0001X
General Practice Dentistry
Primary
NC5490
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031T0
BCBS GROUP #
NC
01
—
89013T0
MEDICAID GROUP #
NC
05
—
8990110
—
NC
01
—
90110
BCBS IND. #
NC
Enumeration date
01/13/2006
Last updated
07/29/2013
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