| NPI | 1164134599 |
|---|---|
| Doing Business As | STONES RIVER DENTAL |
| Entity Type | Organization |
| Authorized Contact | WILL PACK Controller 931-247-8102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2022-12-16 |