Organization
ANTHONY FERRERA DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY W FERRERA DDS (OWNER)
(650) 697-4999
Entity
Organization
Contact information
Practice address
1740 MARCO POLO WAY, SUITE #12, BURLINGAME, CA 94010-4522
(650) 697-4999
(650) 697-7625
Mailing address
1740 MARCO POLO WAY, SUITE #12, BURLINGAME, CA 94010-4522
(650) 697-4999
(650) 697-7625
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
57429
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6598950001
DME PTAN
CA
01
—
FI115A
PTAN
—
Enumeration date
11/15/2011
Last updated
11/21/2011
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