Provider Demographics
NPI:1679865026
Name:FERGUSON, WILLIAM ROBERT III (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:FERGUSON
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BAYARD RD APT 116
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1904
Mailing Address - Country:US
Mailing Address - Phone:412-335-6535
Mailing Address - Fax:
Practice Address - Street 1:4880 LIBRARY RD STE F
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102
Practice Address - Country:US
Practice Address - Phone:412-831-3853
Practice Address - Fax:412-831-7425
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2018-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist