Provider Demographics
NPI:1720065402
Name:FARREN, SETH T (DDS)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:T
Last Name:FARREN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CARMEN AVE
Mailing Address - Street 2:2G
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554
Mailing Address - Country:US
Mailing Address - Phone:516-572-6895
Mailing Address - Fax:516-572-5379
Practice Address - Street 1:200 CARMAN AVE
Practice Address - Street 2:2G
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1147
Practice Address - Country:US
Practice Address - Phone:516-572-6895
Practice Address - Fax:516-572-5379
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0505871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice