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Individual
LACEY FERGUSON
Active
Individual
LACEY FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
00203062
CO
1223G0001X
General Practice Dentistry
009873
AZ
1223G0001X
General Practice Dentistry
102265
CA
1223G0001X
General Practice Dentistry
Primary
31030
TX
Other
Enumeration date
07/15/2015
Last updated
12/13/2018
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