Provider Demographics
NPI:1659773620
Name:FERZLI AND ASSOCIATES DDS, PA
Entity Type:Organization
Organization Name:FERZLI AND ASSOCIATES DDS, PA
Other - Org Name:TMJ & SLEEP THERAPY CENTRE OF RALEIGH-DURHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FERZLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-462-3350
Mailing Address - Street 1:1150 NW MAYNARD RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8708
Mailing Address - Country:US
Mailing Address - Phone:919-462-3350
Mailing Address - Fax:919-462-3360
Practice Address - Street 1:1150 NW MAYNARD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8708
Practice Address - Country:US
Practice Address - Phone:919-462-3350
Practice Address - Fax:919-462-3360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty