Provider Demographics
NPI:1386693075
Name:FARLEY, VICTORIA K (DDS)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:K
Last Name:FARLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3201 S 23RD ST
Mailing Address - Street 2:APT 115
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-5208
Mailing Address - Country:US
Mailing Address - Phone:325-696-2304
Mailing Address - Fax:
Practice Address - Street 1:697 LOUISIANA DRIVE
Practice Address - Street 2:SUITE 1C9
Practice Address - City:DYESS AFB
Practice Address - State:TX
Practice Address - Zip Code:79607-1467
Practice Address - Country:US
Practice Address - Phone:325-696-2304
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3949122300000X
MS2073-84122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist