Provider Demographics
NPI:1881812469
Name:FERRELL, RONALD DAVID (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:DAVID
Last Name:FERRELL
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 1:433 CHASE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-2334
Mailing Address - Country:US
Mailing Address - Phone:361-991-4057
Mailing Address - Fax:
Practice Address - Street 1:4737 MOUNT VERNON DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-3906
Practice Address - Country:US
Practice Address - Phone:361-853-0439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice