Provider Demographics
NPI:1316284656
Name:FERRIS FAMILY DENTISTRY
Entity type:Organization
Organization Name:FERRIS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-215-8909
Mailing Address - Street 1:454 FM 664
Mailing Address - Street 2:SUITE B
Mailing Address - City:FERRIS
Mailing Address - State:TX
Mailing Address - Zip Code:75125
Mailing Address - Country:US
Mailing Address - Phone:972-215-8909
Mailing Address - Fax:
Practice Address - Street 1:454 FM 664
Practice Address - Street 2:SUITE B
Practice Address - City:FERRIS
Practice Address - State:TX
Practice Address - Zip Code:75125
Practice Address - Country:US
Practice Address - Phone:972-215-8909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty