| NPI | 1083624613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN DAVID MCCOY Dentist/President 423-479-2854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN DS0000002113) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |