Organization
SOUTHERN COMFORT DENTAL ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WILSON DMD (PRESIDENT)
(720) 936-9168
Entity
Organization
Contact information
Practice address
4032 BALMORAL DR SW, HUNTSVILLE, AL 35801-6402
(720) 936-9168
Mailing address
108 MEADOWGLADE LN, MADISON, AL 35758-6851
(720) 936-9168
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/26/2022
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