Provider Demographics
NPI:1750508800
Name:AMY . FERGUSON-LAWRENCE DDS APDC
Entity Type:Organization
Organization Name:AMY . FERGUSON-LAWRENCE DDS APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:P
Authorized Official - Last Name:FERGUSON-LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-667-6889
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:
Mailing Address - City:WATSON
Mailing Address - State:LA
Mailing Address - Zip Code:70786-0728
Mailing Address - Country:US
Mailing Address - Phone:225-667-6889
Mailing Address - Fax:225-667-6877
Practice Address - Street 1:34287 LA HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70706-0665
Practice Address - Country:US
Practice Address - Phone:225-667-6889
Practice Address - Fax:225-667-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty