Provider Demographics
NPI:1144078429
Name:FERRER-MENDOZA, SUZZANE SANCHEZ (RDH)
Entity type:Individual
Prefix:
First Name:SUZZANE
Middle Name:SANCHEZ
Last Name:FERRER-MENDOZA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5716
Mailing Address - Country:US
Mailing Address - Phone:415-448-1500
Mailing Address - Fax:
Practice Address - Street 1:411 4TH ST
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5716
Practice Address - Country:US
Practice Address - Phone:448-150-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist