Provider Demographics
NPI:1184793051
Name:FERRARI, JON R (DDS)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:R
Last Name:FERRARI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RIVER ROAD BLDG KL AB
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045
Mailing Address - Country:US
Mailing Address - Phone:973-263-2967
Mailing Address - Fax:973-263-4193
Practice Address - Street 1:150 RIVER ROAD BLDG KL AB
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045
Practice Address - Country:US
Practice Address - Phone:973-263-2967
Practice Address - Fax:973-263-4193
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI018214001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice