Ferguson, Fred Shakespeare

Ferguson, Fred Shakespeare is an individual health care provider with primary practice located at Stony Brook Dental Associates Sullivan Hall Rm 170, Stony Brook NY 11794-0001. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Ferguson, Fred Shakespeare can be contacted via phone (631) 632-8971.

Contact Information

Primary practice address
Stony Brook Dental Associates Sullivan Hall Rm 170 Stony Brook NY 11794-0001
Phone: (631) 632-8971
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 031804 New York

Profile Details

NPI number 1194856872
LBN Legal business name Ferguson, Fred Shakespeare
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1194856872 NPPES
New York MEDICAID 00675654

Popular Providers