| NPI | 1881922466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER A WRIGHT Mbr 662-369-2063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 1860-79) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 3463-08) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |