Healthcare Provider Details

I. General information

NPI: 1598546889
Provider Name (Legal Business Name): CFD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 CLIFTY DR
MADISON IN
47250-1614
US

IV. Provider business mailing address

7162 W STATE ROAD 46
COLUMBUS IN
47201-4695
US

V. Phone/Fax

Practice location:
  • Phone: 812-273-0207
  • Fax:
Mailing address:
  • Phone: 812-447-9935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHERINE E FERRY
Title or Position: OWNER
Credential: DDS, MSD
Phone: 812-350-4465