| NPI | 1144776014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEE COX Owner/Member 865-546-0625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 4786) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 9464) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |