NPI | 1003361130 |
---|---|
Entity Type | Organization |
Authorized Contact | ETTIENNE VAN ZYL President 901-457-7753 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223E0200X Dentist, Endodontics | |
1223P0221X Dentist, Pediatric Dentistry | |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2016-08-18 |
Last Update Date | 2016-08-18 |