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 |