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Individual
JERREN NIKKO FERGUSON
Active
Individual
JERREN NIKKO FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105751
CA
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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