| NPI | 1003160599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH E BEARD President 423-476-6541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 2223) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |