| NPI | 1841449105 |
|---|---|
| Other Name | FERGUSON DENTAL |
| Entity Type | Organization |
| Authorized Contact | TASHA BLACKMON CEO 616-776-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2023-08-25 |