Provider Demographics
NPI:1073624854
Name:FARR, MICHAEL IRVING (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:IRVING
Last Name:FARR
Suffix:
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 1:637 HINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2631
Mailing Address - Country:US
Mailing Address - Phone:847-923-0775
Mailing Address - Fax:847-381-7665
Practice Address - Street 1:118 BARRINGTON COMMONS CT
Practice Address - Street 2:SUITE 201
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3297
Practice Address - Country:US
Practice Address - Phone:847-381-7290
Practice Address - Fax:847-381-7665
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190267471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice