Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DEN.00204318 | CO |
N | 1223P0221X | Pediatric Dentist | DI02714700 | NJ |
NPI | 1013379858 |
---|---|
Provider Name | Dr. Michelle Ferraioli |
First Address | Longmont, CO 80501-3253 |
Second Address | Longmont, CO 80501-3253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 31/05/2020 |