Provider Demographics
NPI:1710051586
Name:LISA A. FERRARI, D.M.D., L.L.C.
Entity Type:Organization
Organization Name:LISA A. FERRARI, D.M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERRARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-385-3056
Mailing Address - Street 1:1208 BEN FRANKLIN HWY W
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1832
Mailing Address - Country:US
Mailing Address - Phone:610-385-3056
Mailing Address - Fax:610-385-0046
Practice Address - Street 1:1208 BEN FRANKLIN HWY W
Practice Address - Street 2:
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-1832
Practice Address - Country:US
Practice Address - Phone:610-385-3056
Practice Address - Fax:610-385-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026272-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty