Provider Demographics
NPI:1083788491
Name:FARRAR, MARIE BOND (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:BOND
Last Name:FARRAR
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:MARIE
Other - Middle Name:FARRAR
Other - Last Name:BALDREE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS MS
Mailing Address - Street 1:204 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-1136
Mailing Address - Country:US
Mailing Address - Phone:423-531-4533
Mailing Address - Fax:423-265-8206
Practice Address - Street 1:204 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1136
Practice Address - Country:US
Practice Address - Phone:423-531-4533
Practice Address - Fax:423-265-8206
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS51631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics