Provider Demographics
NPI:1437510146
Name:FARR, JEFFREY BRYCE (DDS)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:BRYCE
Last Name:FARR
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 1:3031 GRAND AVE # 198
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6698
Mailing Address - Country:US
Mailing Address - Phone:406-318-5611
Mailing Address - Fax:
Practice Address - Street 1:3031 GRAND AVE # 198
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6698
Practice Address - Country:US
Practice Address - Phone:406-318-5611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-DEN-LIC-21366122300000X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No122300000XDental ProvidersDentist