| NPI | 1578991162 |
|---|---|
| Doing Business As | YOUR FAMILY DENTIST |
| Entity Type | Organization |
| Authorized Contact | MICHAEL P WILSON Owner President 607-238-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 62234) |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2013-10-17 |