| Richard E. Ferguson D.d.s.,m.s. Pa | |
|
813 Stilson Rd Ste C Boise ID 83703-5119 | |
| (208) 344-0908 | |
| (208) 338-0306 |
| Full Name | Richard E. Ferguson D.d.s.,m.s. Pa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 813 Stilson Rd Ste C, Boise, Idaho |
| Authorized Official Name and Position | Richard E. Ferguson (OWNER) |
| Authorized Official Contact | 2083440908 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard E. Ferguson D.d.s.,m.s. Pa 813 Stilson Rd Ste C Boise ID 83703-5119 Ph: (208) 344-0908 | Richard E. Ferguson D.d.s.,m.s. Pa 813 Stilson Rd Ste C Boise ID 83703-5119 Ph: (208) 344-0908 |
| NPI Number | 1588827125 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 07/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588827125 | NPI | - | NPPES |
| 000195500 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | D-1669-PE (Idaho) | Primary |
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