| NPI | 1033293311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER ALAN WRIGHT Chairman Of The Board 662-369-2063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 1860-79) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |