Healthcare Provider Details

I. General information

NPI: 1013354711
Provider Name (Legal Business Name): JOSHUA ROBERT FERRARO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4911 W ST JOE HWY
LANSING MI
48917-4088
US

IV. Provider business mailing address

4911 W ST JOE HWY
LANSING MI
48917-4088
US

V. Phone/Fax

Practice location:
  • Phone: 517-321-1848
  • Fax:
Mailing address:
  • Phone: 517-321-1848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901020926
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: