Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 6394 | NC |
NPI | 1063631653 |
---|---|
Provider Name | Dr. Cynthia S. Wiley |
First Address | Goldsboro, NC 27534-1726 |
Second Address | Goldsboro, NC 27534-1726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |