Basic Information
| Provider Information | |||||||||
| NPI: | 1811043292 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | KATHY J FARLEY DDS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 RIDGELY AVE | ||||||||
| Address2: | SUITE 217 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214018804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102241105 | ||||||||
| FaxNumber: | 4102241108 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 RIDGELY AVE | ||||||||
| Address2: | SUITE 217 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214018804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102241105 | ||||||||
| FaxNumber: | 4102241108 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | FARLEY | ||||||||
| AuthorizedOfficialFirstName: | KATHY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4102241105 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DDS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 10055 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist |
No ID Information.