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Individual

DR. ROBERT R FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
202 N MAIN ST, GORDON, NE 69343-1240
(308) 282-1205
Mailing address
202 N MAIN ST, GORDON, NE 69343-1240
(308) 282-1205

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5000
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47-0642874
EMPLOYEER ID NUMBER
NE
Enumeration date
05/27/2007
Last updated
07/08/2007
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