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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194856872 | NPPES |
| New York | MEDICAID | 00675654 |
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