| NPI | 1063562460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BAKER FELTS President 423-756-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: TN DS3107) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: TN DS9462) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2017-02-28 |