Provider Demographics
NPI:1356322176
Name:FERRIS, ALFRED MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:MICHAEL
Last Name:FERRIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6534
Mailing Address - Country:US
Mailing Address - Phone:413-443-3054
Mailing Address - Fax:
Practice Address - Street 1:172 ELM ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6534
Practice Address - Country:US
Practice Address - Phone:413-443-3054
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA94791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice