| NPI | 1063486926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER CAVE WILSON President 605-348-6818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: SD M367) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-08-22 |