Provider Demographics
NPI:1831238781
Name:FERGUSON, JOSEPH GARRETT (DDS)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:GARRETT
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 1:308 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432
Mailing Address - Country:US
Mailing Address - Phone:785-632-6822
Mailing Address - Fax:785-632-6833
Practice Address - Street 1:308 COURT STREET
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432
Practice Address - Country:US
Practice Address - Phone:785-632-6822
Practice Address - Fax:785-632-6833
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS600211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice