Organization
FERGUS ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GWYNNE MASON FERGUS DDS,MS (SOLE MBR)
(870) 336-3366
Entity
Organization
Contact information
Practice address
801 OSLER DRIVE, SUITE D, JONESBORO, AR 72401
(870) 336-3366
(870) 336-3366
Mailing address
801 OSLER DRIVE, SUITE D, JONESBORO, AR 72401
(870) 336-3366
(870) 336-3366
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
115
AR
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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