DR. IAN MACKENZIE FARNHAM, D.D.S.
Dentist at San Jose Blvd, Jacksonville, FL

License number
Florida DN 20520
Category
Dentist
Type
General Practice
Address
Address
11528 San Jose Blvd, Jacksonville, FL 32223
Phone
(904) 673-9717
National Provider ID: 1427474139
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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IAN MACKENZIE FARNHAM, DDS, PLLC

11528 San Jose Blvd, Jacksonville, FL 32223

Status:
Inactive
Inactive reason:
Lc Name Change
Registration:
Jun 24, 2014
Inactive since:
Jul 18, 2014
State ID:
L14000100937
Business type:
Florida Limited Liability Company
Farnham, Ian Mackenzie, Dr, 11528 San Jose Blvd, Jacksonville, FL 32223 (Physical)
Agent:
Maxwell, Ronald W, Esq,1812 University Blvd S, Jacksonville, FL 32216 (Physical)
FEI/EIN:
47-1206491

Professional information

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Ian Mackenzie Farnham Photo 1
Ian Mackenzie Farnham, Jacksonville FL

Ian Mackenzie Farnham, Jacksonville FL
Specialties:
Dentist
Address:
11528 San Jose Blvd, Jacksonville, FL 32223

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