Organization
CELEBRACES WALZEM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID B FERGUSON DDS, CAGS (MANAGING OFFICER)
(210) 683-6353
Entity
Organization
Contact information
Practice address
5201 WALZEM RD, WINDCREST, TX 78218-2122
(210) 683-6353
(210) 451-0000
Mailing address
5201 WALZEM RD, WINDCREST, TX 78218-2122
(210) 683-6353
(210) 451-0000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
24904
TX
Other
Enumeration date
07/18/2015
Last updated
07/18/2015
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