Provider Demographics
NPI:1699295352
Name:FERRANTE, KATHRYN WEBER (DMD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:WEBER
Last Name:FERRANTE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ELLEN
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 MAPLE AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1128
Mailing Address - Country:US
Mailing Address - Phone:954-729-1811
Mailing Address - Fax:
Practice Address - Street 1:976 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-7413
Practice Address - Country:US
Practice Address - Phone:781-894-3143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18575971223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice