| NPI | 1235427691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY JO OGLES Office Manager 615-373-9889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 8056) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 8055) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |