Provider Demographics
NPI:1285625806
Name:FERGUSON, JAMES LEO JR (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEO
Last Name:FERGUSON
Suffix:JR
Gender:M
Credentials:DDS, MSD
Other - Prefix:
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Mailing Address - Street 1:100 COVEY DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5665
Mailing Address - Country:US
Mailing Address - Phone:615-794-0698
Mailing Address - Fax:
Practice Address - Street 1:100 COVEY DR
Practice Address - Street 2:SUITE 301
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5665
Practice Address - Country:US
Practice Address - Phone:615-794-0698
Practice Address - Fax:615-794-3511
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDS0020431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics