Healthcare Provider Details

I. General information

NPI: 1740994037
Provider Name (Legal Business Name): KEAR & FERGUSON DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 01/11/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 HENDERSON RD
COLUMBUS OH
43220-2401
US

IV. Provider business mailing address

2027 HENDERSON RD
COLUMBUS OH
43220-2401
US

V. Phone/Fax

Practice location:
  • Phone: 614-459-5511
  • Fax: 614-459-5466
Mailing address:
  • Phone: 614-459-5511
  • Fax: 614-459-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JUDAH BRUSH
Title or Position: OFFICE MANAGER
Credential:
Phone: 614-459-5511