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General NPI Number Information
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NPI Number | 1013379858
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Entity Type | Individual
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Provider Name | MICHELLE FERRAIOLI DDS
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 2055 KEN PRATT BLVD STE B
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City | LONGMONT
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State | CO
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Zip | 80501-6596
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Country | US
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Telephone | 303-776-1194
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Fax |
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Provider Business Mailing Address
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Address Line | 251 PEAR LAKE WAY
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City | ERIE
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State | CO
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Zip | 80516-2637
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Country | US
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Telephone | 585-747-7668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DI02714700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DEN.00204318
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License Number State | CO
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