Provider Demographics
NPI:1255561692
Name:FERRARA, LESLIE LITTLE (DMD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:LITTLE
Last Name:FERRARA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E KENNEDY BLVD
Mailing Address - Street 2:SUITE 1425
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5181
Mailing Address - Country:US
Mailing Address - Phone:813-229-8090
Mailing Address - Fax:
Practice Address - Street 1:201 E KENNEDY BLVD
Practice Address - Street 2:SUITE 1425
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5181
Practice Address - Country:US
Practice Address - Phone:813-229-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist