| NPI | 1194881672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE STAINBACK Practice Manager 615-885-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN DS7729) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |