Provider Demographics
NPI:1619188372
Name:FERGUSON-YOUNG, DAPHNE CASSANDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:CASSANDRA
Last Name:FERGUSON-YOUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 LEBANON PIKE
Mailing Address - Street 2:#38
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-2417
Mailing Address - Country:US
Mailing Address - Phone:615-327-6775
Mailing Address - Fax:615-327-6367
Practice Address - Street 1:1005 DR. D.B. TODD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-3599
Practice Address - Country:US
Practice Address - Phone:615-327-6775
Practice Address - Fax:615-327-6367
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS37791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice