Provider Demographics
NPI:1720279680
Name:FERRARO, DANIEL LOUIS (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LOUIS
Last Name:FERRARO
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 1:1810 S BOWEN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3340
Mailing Address - Country:US
Mailing Address - Phone:817-274-8667
Mailing Address - Fax:817-274-5238
Practice Address - Street 1:1810 S BOWEN RD
Practice Address - Street 2:SUITE A
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-3340
Practice Address - Country:US
Practice Address - Phone:817-274-8667
Practice Address - Fax:817-274-5238
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX149291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice