Healthcare Provider Details

I. General information

NPI: 1174747968
Provider Name (Legal Business Name): GEMMA MAGLEO FERRER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 7TH ST
SAN FRANCISCO CA
94103-4003
US

IV. Provider business mailing address

229 7TH ST
SAN FRANCISCO CA
94103-4003
US

V. Phone/Fax

Practice location:
  • Phone: 415-503-6033
  • Fax: 415-503-6098
Mailing address:
  • Phone: 415-503-6033
  • Fax: 415-503-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20363
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number56618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: