Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN17170 | FL |
Y | 1223P0300X | Periodontist | 24301 | TX |
NPI | 1104080605 |
---|---|
Provider Name | Dr. Morgan Colby Ferguson |
First Address | The Woodlands, TX 77380 |
Second Address | The Woodlands, TX 77380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2008 |
Last Update Date | 09/11/2017 |