| NPI | 1124290218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WILLIAM WIEDEMAN President 828-210-7051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC NC7085) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2013-07-29 |