| NPI | 1659447381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN H FERGUSON Owner President 478-453-3445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 7306) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-08-22 |