| NPI | 1083625248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER PATRICK KENNEDY Dr./Owner 865-947-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8101) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-08-22 |