Provider Demographics
NPI:1093894289
Name:FARNSLEY, STEVEN L (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:FARNSLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 GRANT LINE CTR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2103
Mailing Address - Country:US
Mailing Address - Phone:812-949-7677
Mailing Address - Fax:812-949-7671
Practice Address - Street 1:302 GRANT LINE CTR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2103
Practice Address - Country:US
Practice Address - Phone:812-949-7677
Practice Address - Fax:812-949-7671
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120096621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice