Provider Demographics
NPI:1184740896
Name:MCFERRAN, MARK S (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:MCFERRAN
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 1:2002 SPRING ARBOR RD STE C
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-2888
Mailing Address - Country:US
Mailing Address - Phone:517-782-0900
Mailing Address - Fax:517-782-0904
Practice Address - Street 1:2002 SPRING ARBOR RD STE C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-2888
Practice Address - Country:US
Practice Address - Phone:517-782-0900
Practice Address - Fax:517-782-0904
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14517122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI14517OtherLICENSE NUMBER
MI14517OtherLICENSE NUMBER