Provider Demographics
NPI:1699882233
Name:FARLEY, LYNN SUSAN (DDS)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:SUSAN
Last Name:FARLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 COTTAGE LN
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-6788
Mailing Address - Country:US
Mailing Address - Phone:303-229-2595
Mailing Address - Fax:
Practice Address - Street 1:6900 ALDEN DR
Practice Address - Street 2:BLDG 160
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82005-3906
Practice Address - Country:US
Practice Address - Phone:307-773-1846
Practice Address - Fax:307-773-3399
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO85091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice