# FERRELL FORT DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215307913
- **Authorized official:** MRS. LINDA KIDD (OFFICE MANAGER)
- **Authorized official phone:** (601) 485-2494

## Contact information

- **Practice address:** 1903 23RD AVE, MERIDIAN, MS 39301-3108
- **Practice address phone:** (601) 485-2494
- **Mailing address:** 1903 23RD AVE, MERIDIAN, MS 39301-3108
- **Mailing address phone:** (601) 485-2494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2015
- **Last updated:** 10/07/2015