MEDICARE: CRYSTAL D FERGUSON DDS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1487466777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRYSTAL D FERGUSON DDS PLLC

Provider Business Mailing Address
First Line	:	1237 16TH ST NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-4261
Country	:	US
Telephone Number	:	828-358-4844
Fax Number	:	828-358-4845

Provider Business Practice Location Address
First Line	:	1237 16TH ST NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-4261
Country	:	US
Telephone Number	:	828-358-4844
Fax Number	:	828-358-4845

Authorized Official
Title or Position	:	MANAGER/ADMIN
Name	:	MADISON MCCURRY
Credential	:
Telephone Number	:	828-358-4844

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	02/06/2026

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