# JUSTIN FERGUSON, D.D.S., PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BALL & FERGUSON DENTISTRY, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124259668
- **Legal business name:** BALL & FERGUSON DENTISTRY, LLC
- **Authorized official:** DR. JUSTIN WARREN FERGUSON D.D.S. (DENTIST)
- **Authorized official phone:** (276) 889-5141

## Contact information

- **Practice address:** 138 HIGHLANDS DRIVE, LEBANON, VA 24266
- **Practice address phone:** (276) 889-5141
- **Practice address fax:** (276) 889-0770
- **Mailing address:** PO BOX 2518, LEBANON, VA 24266-2518
- **Mailing address phone:** (276) 889-5141
- **Mailing address fax:** (276) 889-0770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401-410923 | VA | Yes |

## Other

- **Enumeration date:** 07/31/2009
- **Last updated:** 07/31/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9177664 | — | VA |