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General NPI Number Information
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NPI Number | 1164903068
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Entity Type | Organization
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Legal Business Name | THOMAS R FERRELL II, DDS, PA
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 1824 E ARBORS DR STE 380
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City | CHARLOTTE
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State | NC
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Zip | 28262-2693
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Country | US
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Telephone | 704-307-0950
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 BROOKLINE DR
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-0617
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Country | US
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Telephone | 704-307-0950
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS FERRELL
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Credential |
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Telephone | 704-439-3191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 7849
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License Number State | NC
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