| NPI | 1073238499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID B FERGUSON Owner 210-725-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2022-10-07 |