| NPI | 1144765793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY THOMPSON Business Assistant 423-246-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 3041) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TN 5285) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-01-05 |