Provider Demographics
NPI:1982447868
Name:FARRIS, CHRISTOPHER CHANCE (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CHANCE
Last Name:FARRIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LYNN LN APT 200
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-5763
Mailing Address - Country:US
Mailing Address - Phone:601-325-8242
Mailing Address - Fax:
Practice Address - Street 1:100 G T THAMES DR STE A
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-8836
Practice Address - Country:US
Practice Address - Phone:601-325-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4448-241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice