Individual
KEVIN MATTHEW FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
805 S 500 W, PAYSON, UT 84651-3203
(801) 592-6067
Mailing address
805 S 500 W STE 10, PAYSON, UT 84651-3229
(801) 592-6067
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11739476-9923
UT
1223G0001X
General Practice Dentistry
11739476
UT
Other
Enumeration date
06/12/2020
Last updated
05/13/2024
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