| NPI | 1609846971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE HAND President 251-233-3024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 901) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WY 529) |
| 124Q00000X Dental Hygienist (Licence: WY 571) | |
| 124Q00000X Dental Hygienist (Licence: WY 837) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2010-06-03 |