Provider Demographics
NPI:1043228877
Name:FARREN, MARY F (DMD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:FARREN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:FARREN
Other - Last Name:BERKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1908 SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2003
Mailing Address - Country:US
Mailing Address - Phone:856-751-6606
Mailing Address - Fax:856-751-6607
Practice Address - Street 1:1908 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2003
Practice Address - Country:US
Practice Address - Phone:856-751-6606
Practice Address - Fax:856-751-6607
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ21203511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice