| NPI | 1134725633 |
|---|---|
| Other Name | C. MICHAEL WISE, FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHARLES M WISE Dds 501-268-8634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |