| NPI | 1053623223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELBIN RODRIGUEZ President 865-689-7556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8820) |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2010-07-05 |