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Individual

ANDREW BENJAMIN FARMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
305 MORTON BLVD, HAZARD, KY 41701-9418
(606) 436-5437
Mailing address
PO BOX 388, HYDEN, KY 41749-0388
(606) 275-4686

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8883
KY
1223P0221X
Pediatric Dentistry
Primary
8883
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100200040
KY
Enumeration date
06/18/2010
Last updated
08/03/2012
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