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Organization
NICOLE FARR DMD PC
Active
Organization
NICOLE FARR DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE FARR DMD (DENTIST/OWNER/PRESIDENT)
(818) 625-3235
Entity
Organization
Contact information
Practice address
427 N LARCHMONT BLVD, LOS ANGELES, CA 90004-3013
(323) 467-1355
Mailing address
427 N LARCHMONT BLVD, LOS ANGELES, CA 90004-3013
(323) 467-1355
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100263
PPO AND FFS ONLY
CA
Enumeration date
08/06/2019
Last updated
08/06/2019
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