Provider Demographics
NPI:1730145541
Name:FARLEY, SHEILA LYNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:LYNN
Last Name:FARLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CHIMNEY CROSS
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:MS
Mailing Address - Zip Code:39560-6313
Mailing Address - Country:US
Mailing Address - Phone:228-383-0869
Mailing Address - Fax:
Practice Address - Street 1:902 E RAILROAD ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:MS
Practice Address - Zip Code:39560-5025
Practice Address - Country:US
Practice Address - Phone:228-214-3650
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3350-051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice