| NPI | 1619140928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALDOUS WILSON Owner 678-206-0199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011947) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |