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General NPI Number Information
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NPI Number | 1942258397
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Entity Type | Individual
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Provider Name | HENRY W FERGUSON DMD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 1430 JOHN WESLEY GILBERT DRIVE
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City | AUGUSTA
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State | GA
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Zip | 30912-1001
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Country | US
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Telephone | 706-721-9744
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Fax | 706-721-6778
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Provider Business Mailing Address
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Address Line | 1430 JOHN WESLEY GILBERT DRIVE GC-1012
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-7913
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Fax | 706-721-6778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 3663
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | DN012107
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | DNGA000189
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License Number State | GA
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