| NPI | 1184268815 |
|---|---|
| Doing Business As | WIREGRASS SMILES |
| Entity Type | Organization |
| Authorized Contact | SYLVIA J MILLER I Nsurance COO Rdinator 321-431-2208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |