| NPI | 1063430924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES G WOOD Dentist 228-863-5171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2041-83) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |