| NPI | 1205257599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY G BIRDSONG Office Manager 931-685-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 3046) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 9671) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2014-01-03 |