MEDICARE: KEAR & FERGUSON DDS INC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1740994037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEAR & FERGUSON DDS INC

Provider Business Mailing Address
First Line	:	2027 HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2401
Country	:	US
Telephone Number	:	614-459-5511
Fax Number	:	614-459-5466

Provider Business Practice Location Address
First Line	:	2027 HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2401
Country	:	US
Telephone Number	:	614-459-5511
Fax Number	:	614-459-5466

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JUDAH BRUSH
Credential	:
Telephone Number	:	614-459-5511

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	01/11/2023

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