Provider Demographics
NPI:1265554299
Name:FERA, JOSEPH A (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:FERA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 LINCOLN WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15131-1642
Mailing Address - Country:US
Mailing Address - Phone:412-672-6477
Mailing Address - Fax:412-664-1157
Practice Address - Street 1:1220 LINCOLN WAY
Practice Address - Street 2:STE 200
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15131-1642
Practice Address - Country:US
Practice Address - Phone:412-672-6477
Practice Address - Fax:412-664-1157
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023114L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist