Kelly-Gwynne Mason Fergus in Jonesboro - Orthodontics And Dentofacial Orthopedics
Kelly-Gwynne Mason Fergus - NPI 1093979254
Kelly-Gwynne Mason Fergus is a Orthodontics And Dentofacial Orthopedics in Jonesboro, Arkansas. Kelly-Gwynne Mason Fergus practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for Kelly-Gwynne Mason Fergus is 1093979254. The last update date is 2015-06-02.
Kelly-Gwynne Mason Fergus's current location address is 2812 Harrisburg Rd, Jonesboro, Arkansas. You can contact this provider via phone number 8703363366 and fax number 8703363360. The mailing address for Kelly-Gwynne Mason Fergus is 2812 Harrisburg Rd, Jonesboro, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly-Gwynne Mason Fergus |
|---|---|
| Address | 2812 Harrisburg Rd, Jonesboro, Arkansas |
| Phone Number | 8703363366 |
| Fax Number | 8703363360 |
| Sole Proprietor | Y |
| Credentials | DDS, MDS |
NPI Number Detail
| NPI Number | 1093979254 |
|---|---|
| Provider Enumeration Date | 2008-07-16 |
| Last Updated Date | 2015-06-02 |
Provider Mailing Address Detail
| Address | 2812 Harrisburg Rd |
|---|---|
| City | Jonesboro |
| State | Arkansas (AR) |
| Post Code | 724016081 |
| Phone Number | 8703363366 |
| Fax Number | 8703363360 |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | 3659 |
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Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
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What is the unique provider identifier assigned to Kelly-Gwynne Mason Fergus?
The Kelly-Gwynne Mason Fergus has been issued the NPI (National Provider Identifier) 1093979254 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Kelly-Gwynne Mason Fergus?
The Kelly-Gwynne Mason Fergus is situated at 2812 Harrisburg Rd, in the city of Jonesboro, state of AR, with the zip code 724016081.
What is Kelly-Gwynne Mason Fergus's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kelly-Gwynne Mason Fergus's area of specialization is Orthodontics And Dentofacial Orthopedics, and the corresponding taxonomy code that categorizes this field of practice is 1223X0400X.
When did Kelly-Gwynne Mason Fergus receive its 1093979254 assignment?
The Kelly-Gwynne Mason Fergus was assigned its 1093979254 on 2008-07-16, which is the date when this unique identifier was issued to the organization.
When was the information regarding Kelly-Gwynne Mason Fergus most recently updated?
The details pertaining to the Kelly-Gwynne Mason Fergus, including its address, specialty, and other relevant information, were last refreshed on 2015-06-02.