| NPI | 1124384177 |
|---|---|
| Doing Business As | BIG SANDY PUBLIC HEALTH DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ANCIL LEWIS CEO 606-886-8546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |