| NPI | 1144772583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YADNAY TABARES President 615-477-4047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN20019) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |