| NPI | 1063545820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG BURDETTE WIGGINS Orthodontist Owner 502-223-1656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 3945) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |