Individual
JOHN FARAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3142 CHENEY HIGHWAY, TITUSVILLE, FL 32780-7404
(321) 614-0486
Mailing address
11777 LAKE LUCAYA DR, RIVERVIEW, FL 33579-4126
(321) 614-0486
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21561
FL
Other
Enumeration date
08/24/2015
Last updated
07/06/2021
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