| NPI | 1760501001 |
|---|---|
| Doing Business As | CHILDREN'S DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TRACY LYNN WILKERSON Pediatric Specialist 304-345-0541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WV 3529) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |