| NPI | 1457735441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID B FERGUSON Managing Officer 210-683-6353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 24904) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |