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
Phone: (920) 686-2333
Fax: (920) 783-6392
Website:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851703458 | NPPES |
| Wisconsin | MEDICAID | 100037927 |
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