| NPI | 1265604144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK C SMITH Pediatric Dentist 423-639-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TN DS4229) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TN DS4016) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |