Provider Demographics
NPI:1366580771
Name:FARNHAM & FARNHAM PA
Entity type:Organization
Organization Name:FARNHAM & FARNHAM PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUTTON
Authorized Official - Middle Name:
Authorized Official - Last Name:FARNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PHD
Authorized Official - Phone:904-262-2551
Mailing Address - Street 1:11528 SAN JOSE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223
Mailing Address - Country:US
Mailing Address - Phone:904-262-2551
Mailing Address - Fax:904-262-2930
Practice Address - Street 1:11528 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223
Practice Address - Country:US
Practice Address - Phone:904-262-2551
Practice Address - Fax:904-262-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty