Provider Demographics
NPI:1285013516
Name:UNVERFERTH, ERICA (DDS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:UNVERFERTH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 FOX RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2451
Mailing Address - Country:US
Mailing Address - Phone:419-238-4385
Mailing Address - Fax:419-238-9228
Practice Address - Street 1:707 FOX RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2451
Practice Address - Country:US
Practice Address - Phone:419-238-4385
Practice Address - Fax:419-238-9228
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024488122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist