Individual provider · Type 1 NPI
Kelly-Gwynne Mason Fergus, DDS, MDS
Orthodontics and Dentofacial Orthopedics Dentistry · Jonesboro, AR
Practice location
2812 Harrisburg Rd
Jonesboro, AR 72401-6081
Fax (870) 336-3360
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 3659 (AR) |
Orthodontics and Dentofacial Orthopedics Dentistry: 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 related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1093979254
Kelly-Gwynne Mason Fergus, DDS, MDS's National Provider Identifier is 1093979254, issued on Jul 16, 2008. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Jonesboro, AR. The record was last updated on Jun 2, 2015.