Provider Demographics
NPI:1770753295
Name:FERMIN, MARIA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:FERMIN
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 1:2182 NE 123 RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181
Mailing Address - Country:US
Mailing Address - Phone:305-893-8170
Mailing Address - Fax:305-891-7863
Practice Address - Street 1:2182 NE 123RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2902
Practice Address - Country:US
Practice Address - Phone:305-893-8170
Practice Address - Fax:305-891-7863
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 173301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice