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Organization
RICHARD E. FERGUSON D.D.S.,M.S. PA
Active
Organization
RICHARD E. FERGUSON D.D.S.,M.S. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD E. FERGUSON D.D.S., M.S. (OWNER)
(208) 344-0908
Entity
Organization
Contact information
Practice address
813 STILSON RD STE C, BOISE, ID 83703-5119
(208) 344-0908
(208) 338-0306
Mailing address
813 STILSON RD STE C, BOISE, ID 83703-5119
(208) 344-0908
(208) 338-0306
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D-1669-PE
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000195500
—
ID
Enumeration date
07/03/2008
Last updated
07/03/2008
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