| NPI | 1235468760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA LYNN EADES Owner/Dentist 865-671-1255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN 8200) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2011-10-27 |