Sandra Ferguson, RDH

Individual provider Active NPI Dental Hygienist · Crownpoint, NM

NPI 1902020274 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1902020274
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
202360 (CO)
Practice address
Highway 371 Junction Route 9
Crownpoint, NM 87313-0358
Phone
(505) 786-5291
Fax
(505) 786-6440
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
202360COMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 202360 CO Yes

Addresses

Primary practice location

Highway 371 Junction Route 9
Crownpoint, NM 87313-0358

Mailing address

PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-5291

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · Dental Hygienist in New Mexico

Sources for this page

Verify at the official NPI Registry.