Provider Demographics
NPI:1235333014
Name:FARRAR, AMY TABORN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:TABORN
Last Name:FARRAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 SOUTHERN DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6001
Mailing Address - Country:US
Mailing Address - Phone:919-308-9821
Mailing Address - Fax:
Practice Address - Street 1:7010 NC HIGHWAY 751
Practice Address - Street 2:SUITE 103
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5733
Practice Address - Country:US
Practice Address - Phone:919-973-5696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice