| NPI | 1275809394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID OWEN PICKETT President 865-691-0918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2023-08-25 |