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General NPI Number Information
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NPI Number | 1265538367
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Entity Type | Organization
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Legal Business Name | DAVID S. FERRY III, DDS & KELLEY L. BORDERS, DMD, PL
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1805 W REYNOLDS ST
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City | PLANT CITY
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State | FL
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Zip | 33563-4739
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Country | US
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Telephone | 813-754-2605
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Fax | 813-752-7436
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Provider Business Mailing Address
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Address Line | 1805 W REYNOLDS ST
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City | PLANT CITY
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State | FL
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Zip | 33563-4739
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Country | US
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Telephone | 813-754-2605
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Fax | 813-752-7436
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Authorized Official
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Title or Position | OWNER
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Name | DR. KELLEY LYNN BORDERS
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Credential | DMD
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Telephone | 813-754-2605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 7245
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 16284
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License Number State | FL
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