Organization
FERGUSON KUTANSKY, PLLC
Active
Other names
Nevada Dental Arts
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON E FERGUSON DDS (OWNER)
(775) 426-8293
Entity
Organization
Contact information
Practice address
56 COMMERCIAL WAY, FALLON, NV 89406-2600
(775) 423-9990
(775) 423-9992
Mailing address
56 COMMERCIAL WAY, FALLON, NV 89406-2600
(775) 423-9990
(775) 423-9992
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4641
NV
1223G0001X
General Practice Dentistry
5064
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174678163
INDIVIDUAL NATIONAL PROVIDER #
NV
01
—
1528113594
INDIVIDUAL NATIONAL PROVIDER #
NV
Enumeration date
03/13/2012
Last updated
03/13/2012
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