Provider Demographics
NPI:1700945938
Name:FAROLE, ANTHONY (DMD)
Entity type:Individual
Prefix:PROF
First Name:ANTHONY
Middle Name:
Last Name:FAROLE
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 1:380 SHELBOURNE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-5743
Mailing Address - Country:US
Mailing Address - Phone:610-668-3300
Mailing Address - Fax:
Practice Address - Street 1:2 BALA PLZ
Practice Address - Street 2:SUITE IL-25
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1501
Practice Address - Country:US
Practice Address - Phone:610-668-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022779L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery