| NPI | 1053690446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTA LORI CREWS Office Manager 931-487-9997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS8581) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2011-08-16 |