Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DEN-DEN-LIC-21366 | MT |
Y | 1223D0004X | Dentist Anesthesiologist | DEN-DEN-LIC-21366 | MT |
NPI | 1437510146 |
---|---|
Provider Name | Jeffrey Bryce Farr |
First Address | Billings, MT 59102-6698 |
Second Address | Billings, MT 59102-6698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2016 |
Last Update Date | 03/08/2021 |