| NPI | 1023264322 |
|---|---|
| Other Name | COSMETIC AND FAMILY DENTISTRY OF ROSWELL |
| Entity Type | Organization |
| Authorized Contact | KENNETH MORRIS WIGGINS Dr./Dentist 770-226-0008 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN012485) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN012484) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |