| NPI | 1194943688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD RICHARD HALLIBURTON, D.D.S., M.S. President 423-246-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |