Individual
GEORGE THOMAS WICKERSHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2260 CROSS TIMBERES RD, STE A, FLOWER MOUND, TX 75028
(972) 874-2800
(972) 539-0165
Mailing address
2260 CROSS TIMBERES RD, STE A, FLOWER MOUND, TX 75028
(972) 874-2800
(972) 539-0165
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
17875
TX
Other
Enumeration date
12/29/2006
Last updated
10/03/2007
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