| NPI | 1043994098 |
|---|---|
| Former Legal Business Name | THE GREENLINE DENTIST |
| Entity Type | Organization |
| Authorized Contact | PAIGE GASSMANN Dentist/Owner 901-254-8022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-07-31 |