| NPI | 1003822842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM PAYONK Owner 901-767-3259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS3315) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |