Provider Demographics
NPI:1346375276
Name:FERRY III, DAVID STICKNEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STICKNEY
Last Name:FERRY III
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 W REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4739
Mailing Address - Country:US
Mailing Address - Phone:813-754-2605
Mailing Address - Fax:813-752-7436
Practice Address - Street 1:1805 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4739
Practice Address - Country:US
Practice Address - Phone:813-754-2605
Practice Address - Fax:813-752-7436
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL72451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice