Individual
DR. JUSTIN W FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
138 HIGHLAND DRIVE, LEBANON, VA 24266
(276) 889-5141
(276) 889-0770
Mailing address
833 GLENVIEW DR, ABINGDON, VA 24211-3669
(276) 356-8042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401-410923
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9177664
—
VA
Enumeration date
12/13/2006
Last updated
07/09/2007
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