| NPI | 1851860753 |
|---|---|
| Doing Business As | WOLF RIVER DENTAL CENTER PLLC |
| Entity Type | Organization |
| Authorized Contact | MAX S BREAZEAL Owner 901-491-4859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |