| NPI | 1255502944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG A. SHEPHERD Owner 423-639-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 4696) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-03-20 |