Provider Demographics
NPI:1235111444
Name:FERGUSON, DAVID B (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3145 GARDEN AVE RM 110
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-7718
Mailing Address - Country:US
Mailing Address - Phone:210-808-3737
Mailing Address - Fax:210-808-3802
Practice Address - Street 1:3145 GARDEN AVE RM 110
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-7718
Practice Address - Country:US
Practice Address - Phone:210-808-3737
Practice Address - Fax:210-808-3802
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0154211223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics