| Fergus Orthodontics Pllc | |
|
801 Osler Drive Suite D Jonesboro AR 72401 | |
| (870) 336-3366 | |
| (870) 336-3366 |
| Full Name | Fergus Orthodontics Pllc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 801 Osler Drive, Jonesboro, Arkansas |
| Authorized Official Name and Position | Kelly Gwynne Mason Fergus (SOLE MBR) |
| Authorized Official Contact | 8703363366 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fergus Orthodontics Pllc 801 Osler Drive Suite D Jonesboro AR 72401 Ph: (870) 336-3366 | Fergus Orthodontics Pllc 801 Osler Drive Suite D Jonesboro AR 72401 Ph: (870) 336-3366 |
| NPI Number | 1003194317 |
|---|---|
| Provider Enumeration Date | 08/03/2011 |
| Last Update Date | 08/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003194317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 115 (Arkansas) | Primary |
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