NPI | 1861675738 |
---|---|
Other Name | WAYNE KING |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN DS0000007692) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC 2039) |
1223G0001X Dentist General Practice (Licence: GA DN010090) | |
Enumeration Date | 2007-12-13 |
Last Update Date | 2012-01-04 |