Organization
FARMER FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY A FARMER DDS (OWNER/DENTIST)
(913) 220-8447
Entity
Organization
Contact information
Practice address
2348 IOWA ST, LAWRENCE, KS 66046-3938
(785) 841-4200
Mailing address
2348 IOWA ST, LAWRENCE, KS 66046-3938
(785) 841-4200
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
60402
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19749
—
KS
Enumeration date
05/20/2013
Last updated
05/20/2013
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