| NPI | 1194147421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES T DEBERRY Owner 865-691-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN DS2089) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |