Organization
CELEBRACES PLLC
Active
Organization
CELEBRACES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BURTON FERGUSON (OWNER)
(904) 994-0410
Entity
Organization
Contact information
Practice address
8700 MARBACH RD, SAN ANTONIO, TX 78227-2345
(904) 994-0410
Mailing address
8700 MARBACH RD, SAN ANTONIO, TX 78227-2345
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
24904
TX
Other
Enumeration date
01/11/2011
Last updated
01/11/2011
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