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General NPI Number Information
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NPI Number | 1124719166
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Entity Type | Organization
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Legal Business Name | FERGUSON DENTAL PLLC
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 2572 GUS THOMASSON RD
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City | DALLAS
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State | TX
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Zip | 75228-3017
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Country | US
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Telephone | 469-481-1189
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 E ELDORADO PKWY STE 100
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City | LITTLE ELM
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State | TX
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Zip | 75068-5502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MELISSA SIGMAN
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Credential |
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Telephone | 972-523-0420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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