| NPI | 1114716966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATELYN FERGUSON Practice Manager 615-428-3912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |