Provider Demographics
NPI:1033380571
Name:FERREL DENTAL GROUP PA
Entity Type:Organization
Organization Name:FERREL DENTAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SORAIDA
Authorized Official - Middle Name:MENEZES
Authorized Official - Last Name:FERREL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-821-2233
Mailing Address - Street 1:16363 NW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014
Mailing Address - Country:US
Mailing Address - Phone:305-821-2233
Mailing Address - Fax:
Practice Address - Street 1:16363 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:305-821-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0012895122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty