Provider Demographics
NPI:1558053033
Name:FERGUSON, PARKER J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PARKER
Middle Name:J
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 ANGELO JOSEPH LN APT 106
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-3998
Mailing Address - Country:US
Mailing Address - Phone:801-726-1991
Mailing Address - Fax:
Practice Address - Street 1:4121 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2951
Practice Address - Country:US
Practice Address - Phone:614-231-8000
Practice Address - Fax:614-349-3347
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.027202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist