Individual
DR. AUSTIN P FARMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1039 E INTERSTATE 30 STE 107, ROCKWALL, TX 75087-4912
(972) 722-4914
Mailing address
2828 WOODSIDE ST APT 3111, DALLAS, TX 75204-3090
(806) 787-8190
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2901022419
MI
1223G0001X
General Practice Dentistry
Primary
34670
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34670
TSBDE LICENSURE
TX
Enumeration date
08/23/2017
Last updated
11/18/2019
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