Provider Demographics
NPI:1619246188
Name:FARROW, KRISTINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:
Last Name:FARROW
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:FARROW-CYPEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:10 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3721
Mailing Address - Country:US
Mailing Address - Phone:856-770-8373
Mailing Address - Fax:
Practice Address - Street 1:10 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3721
Practice Address - Country:US
Practice Address - Phone:856-770-8373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01468100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist