Individual
ETHAN G FARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1163 GRAND AVE, HARTFORD, WI 53027-2458
(262) 673-7826
Mailing address
2444 SAND DOLLAR CT, SUAMICO, WI 54313-7986
(920) 660-5799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001184
WI
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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