Organization
CRANIAL FACIAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FERGUSON DDS (ADMINISTRATOR)
(210) 675-7000
Entity
Organization
Contact information
Practice address
1400 W 47TH ST STE 7, LA GRANGE, IL 60525-6148
(210) 675-7000
Mailing address
1400 W 47TH ST STE 7, LA GRANGE, IL 60525-6148
(872) 215-0361
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
174400000X
Specialist
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
Other
Enumeration date
01/26/2026
Last updated
05/06/2026
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