| NPI | 1962723502 |
|---|---|
| Doing Business As | ST. FRANCISVILLE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHARLES BRENT WILSON Owner 225-454-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6033) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2013-07-29 |