| NPI | 1194812354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J WIGLEY Dentist 772-334-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN12093) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |