Provider Demographics
NPI:1205023587
Name:FERREIRA, ANDRE (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 GOLDEN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-7097
Mailing Address - Country:US
Mailing Address - Phone:256-831-7515
Mailing Address - Fax:256-831-7517
Practice Address - Street 1:1677 GOLDEN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-7097
Practice Address - Country:US
Practice Address - Phone:256-831-7515
Practice Address - Fax:256-831-7517
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL54011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics