| NPI | 1265956825 |
|---|---|
| Doing Business As | WIREGRASS DENTAL |
| Entity Type | Organization |
| Authorized Contact | JESSICA NIX UNTERKOFLER Owner 334-347-3061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 21381) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2022-07-21 |