Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 21128 | CA |
NPI | 1609059922 |
---|---|
Provider Name | Dr. Hugo Ferlito |
First Address | Santa Cruz, CA 95065-1819 |
Second Address | Santa Cruz, CA 95065-1819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 10/12/2007 |