Provider Demographics
NPI:1073247052
Name:LELA FARMER DDS MSD
Entity Type:Organization
Organization Name:LELA FARMER DDS MSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LELA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:704-641-4117
Mailing Address - Street 1:3829 LOCKHILL SELMA RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1762
Mailing Address - Country:US
Mailing Address - Phone:210-899-1099
Mailing Address - Fax:
Practice Address - Street 1:3829 LOCKHILL SELMA RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1762
Practice Address - Country:US
Practice Address - Phone:210-899-1099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1841632270OtherNPPES
1992154660OtherNPPES