Individual
RICHARD E FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
813 STILSON RD, SUITE C, BOISE, ID 83703-5119
(208) 344-0908
(208) 338-0306
Mailing address
813 STILSON RD, SUITE 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
Enumeration date
11/16/2006
Last updated
07/09/2007
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