Individual
KEVIN FARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
111 E BROADWAY AVE, MONTESANO, WA 98563-3703
(360) 470-6389
Mailing address
111 E BROADWAY AVE, MONTESANO, WA 98563-3703
(360) 470-6389
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE61155909
WA
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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