# WILSON AND PFAU FAMILY DENTISTRY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013534684
- **Authorized official:** ALICIA BIES-PFAU (OWNER/OFFICE MANAGER)
- **Authorized official phone:** (812) 482-1855

## Contact information

- **Practice address:** 288 NORTHWOOD AVE, JASPER, IN 47546-1212
- **Practice address phone:** (812) 482-1855
- **Practice address fax:** (812) 634-6833
- **Mailing address:** 288 NORTHWOOD AVE, JASPER, IN 47546-1212
- **Mailing address phone:** (812) 482-1855
- **Mailing address fax:** (812) 634-6833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2020
- **Last updated:** 06/30/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1659755197 | NPI (ALEX M PFAU DMD) | IN |
| 01 | — | 1821215781 | NPI (KIM BADELL WILSON DDS) | IN |
| 01 | — | 1841417706 | NPI (J BRAD WILSON DDS) | IN |