Provider Demographics
NPI:1356366975
Name:FERRARI, MARK A (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:FERRARI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10250 COTTONWOOD PARK NW STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-7019
Mailing Address - Country:US
Mailing Address - Phone:055-890-0858
Mailing Address - Fax:055-890-1402
Practice Address - Street 1:10250 COTTONWOOD PARK NW STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-7019
Practice Address - Country:US
Practice Address - Phone:055-890-0858
Practice Address - Fax:055-890-1402
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD52171223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics