Provider Demographics
NPI:1235347667
Name:FARROW, JON STEPHEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:STEPHEN
Last Name:FARROW
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 1:8433 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-9679
Mailing Address - Country:US
Mailing Address - Phone:859-283-1111
Mailing Address - Fax:859-283-0116
Practice Address - Street 1:8433 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-9679
Practice Address - Country:US
Practice Address - Phone:859-283-1111
Practice Address - Fax:859-283-0116
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist