Individual
FORREST M FARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5899 N BELT W, BELLEVILLE, IL 62226-4617
(618) 222-8887
Mailing address
5899 N BELT W, BELLEVILLE, IL 62226-4617
(618) 222-8887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019026486
IL
Other
Enumeration date
01/10/2007
Last updated
01/11/2010
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