Provider Demographics
NPI:1700311842
Name:FERVER, VIRGINIA (PHDHP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:FERVER
Suffix:
Gender:F
Credentials:PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PARK LN
Mailing Address - Street 2:
Mailing Address - City:EARLEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21919-1241
Mailing Address - Country:US
Mailing Address - Phone:443-553-2331
Mailing Address - Fax:610-444-4656
Practice Address - Street 1:731 W CYPRESS ST
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-2419
Practice Address - Country:US
Practice Address - Phone:610-444-7550
Practice Address - Fax:610-444-4656
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPHDH000872124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist