| NPI | 1003272790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABIN KANE EWING Owner 615-256-7543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 7907) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TN 9072) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TN 7907) | |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |