Stream, Tara Ferris

Stream, Tara Ferris is an individual health care provider with primary practice located at 601 Buffalo St , Manitowoc WI 54220-6817. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Stream, Tara Ferris can be contacted via phone (920) 686-2333.

Contact Information

Primary practice address
601 Buffalo St Manitowoc WI 54220-6817
Fax: (920) 783-6392
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 7234-15 Wisconsin

Profile Details

NPI number 1851703458
LBN Legal business name Stream, Tara Ferris
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2014
Last updated Feb 18th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851703458 NPPES
Wisconsin MEDICAID 100037927

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