Ferguson, Larry Jethro
Ferguson, Larry Jethro is an individual health care provider with primary practice located at 1812 Wallace School Road, Suite 400, Charleston SC 29407-4517. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Ferguson, Larry Jethro can be contacted via phone (843) 571-4411.Contact Information
Primary practice address
1812 Wallace School Road, Suite 400
Charleston SC 29407-4517
Phone: (843) 571-4411
Fax: (843) 571-1801
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / General Practice | 1223G0001X | 2262 | South Carolina |
Profile Details
NPI number | 1659322121 |
---|---|
LBN Legal business name | Ferguson, Larry Jethro |
Credentials | Doctor of Dental Medicine (DMD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 12th, 2006 |
Last updated | Jul 8th, 2007 - about 18 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 | 1659322121 | NPPES |
South Carolina | MEDICAID | Z22627 |
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