Provider Demographics
NPI:1134649643
Name:FERRARA, MARGARET GRACE (DDS)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:GRACE
Last Name:FERRARA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 STURGES RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-4957
Mailing Address - Country:US
Mailing Address - Phone:203-981-0960
Mailing Address - Fax:
Practice Address - Street 1:4 CORPORATE DR STE 383
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484
Practice Address - Country:US
Practice Address - Phone:203-242-7721
Practice Address - Fax:203-242-7719
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT122911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program