| NPI | 1467801423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID B FERGUSON Owner 210-683-6353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 24904) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |