NPI | 1073393336 |
---|---|
Doing Business As | ROLLA FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | RYAN MCCOSTLIN CEO 615-479-2196 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2023-10-04 |
Last Update Date | 2023-10-04 |