Provider Demographics
NPI:1700189016
Name:FERMIL, PAIGE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:FERMIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 WINDERMERE PKWY
Mailing Address - Street 2:501
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6103
Mailing Address - Country:US
Mailing Address - Phone:770-889-9600
Mailing Address - Fax:
Practice Address - Street 1:3810 WINDERMERE PKWY
Practice Address - Street 2:501
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6103
Practice Address - Country:US
Practice Address - Phone:770-889-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant