Individual
DR. THOMAS LOUIS FARAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1547 S HIGGINS AVE, MISSOULA, MT 59801-4226
(406) 549-6081
(406) 549-6081
Mailing address
1547 S HIGGINS AVE, MISSOULA, MT 59801-4226
(406) 549-6081
(406) 549-6081
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1680
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011-3997
—
MT
Enumeration date
05/09/2007
Last updated
07/08/2007
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