| NPI | 1023386372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE L WARE Owner/Operator 901-282-5706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MS 3439-07) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-06 |