| NPI | 1154503548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK W HANEY Dentist/Owner 865-693-6886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS7287) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |