Provider Demographics
NPI:1992719488
Name:FERRARIS, VALENTINE ROBERT (DDS)
Entity type:Individual
Prefix:
First Name:VALENTINE
Middle Name:ROBERT
Last Name:FERRARIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:POCASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02559
Mailing Address - Country:US
Mailing Address - Phone:508-563-5540
Mailing Address - Fax:508-563-7326
Practice Address - Street 1:580 MACARTHUR BLVD
Practice Address - Street 2:ROUTE 28
Practice Address - City:POCASSET
Practice Address - State:MA
Practice Address - Zip Code:02559
Practice Address - Country:US
Practice Address - Phone:508-563-5540
Practice Address - Fax:508-563-7326
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA117151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice