George Thomas Wickersham Valid NPI
Individual provider · Pediatric Dentistry · Flower Mound, TX
- NPI
- 1083770465
- Type
- Individual (Type 1)
- Primary specialty
- Pediatric Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223P0221X
- License number
- 17875 (TX)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-12-29
- Last updated
- 2007-10-03
Practice location
2260 Cross Timberes Rd, Ste A
Flower Mound, TX 75028
(972) 874-2800