| NPI | 1396924544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE TAYLOR WILSON President 606-248-1808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 5811) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |