Provider Demographics
NPI:1679737951
Name:ROBIN L. FERGUSON DDS PC
Entity type:Organization
Organization Name:ROBIN L. FERGUSON DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-488-9075
Mailing Address - Street 1:820 E 87TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-6253
Mailing Address - Country:US
Mailing Address - Phone:773-488-9075
Mailing Address - Fax:773-874-6575
Practice Address - Street 1:820 E 87TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-6253
Practice Address - Country:US
Practice Address - Phone:773-488-9075
Practice Address - Fax:773-874-6575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190217941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty