| NPI | 1063814838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUGH D VICE Senior Partner 423-842-0165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN DS0000004055) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |