Provider Demographics
NPI:1912243106
Name:ANTHONY L FARROW
Entity Type:Organization
Organization Name:ANTHONY L FARROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARROW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-569-9060
Mailing Address - Street 1:1601 WALNUT STREET
Mailing Address - Street 2:SUITE 1601
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-569-9060
Mailing Address - Fax:
Practice Address - Street 1:1601 WALNUT STREET
Practice Address - Street 2:SUITE 1601
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:215-569-9060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTHONY L FARROW
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS02421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty