Provider Demographics
NPI:1043431729
Name:FARNETH, JOHN L JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:FARNETH
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1428
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-5428
Mailing Address - Country:US
Mailing Address - Phone:814-765-4681
Mailing Address - Fax:814-765-7475
Practice Address - Street 1:850 LEONARD ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3200
Practice Address - Country:US
Practice Address - Phone:814-765-4681
Practice Address - Fax:814-765-7475
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027808L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice