Individual
DR. KONRAD DAVID FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
BLDG 9900, 2ND FLOOR, U.S. ARMY DENTAL ACTIVITY - FORT LEWIS, TACOMA, WA 98431-1100
(253) 968-4039
(253) 968-5919
Mailing address
BLDG 9900, 2ND FLOOR, U.S. ARMY DENTAL ACTIVITY - FORT LEWIS, TACOMA, WA 98431-1100
(253) 968-4039
(253) 968-5919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60112858
WA
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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