| NPI | 1043745169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON COLLIER Owner 901-756-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN DS0000008695) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |