| NPI | 1215012430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIANN BINGHAM Billing Manager 901-448-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2015-08-28 |