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General NPI Number Information
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NPI Number | 1518372556
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Entity Type | Organization
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Legal Business Name | JOHN D FERRIN DMD LLC
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Dates
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Enumeration Date | 06/28/2014
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 2930 E BARNETT RD
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City | MEDFORD
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State | OR
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Zip | 97504-8309
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Country | US
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Telephone | 541-779-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 2930 E BARNETT RD
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City | MEDFORD
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State | OR
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Zip | 97504-8309
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Country | US
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Telephone | 541-779-4501
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Fax |
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Authorized Official
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Title or Position | OWNER, PERIODONTIST
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Name | DR. JOHN DAVID FERRIN
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Credential | DMD, MS
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Telephone | 541-944-5745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State | OR
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