| NPI | 1174066724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS W STANDIFER Owner/President 423-877-6485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TN 4021) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-12-05 |