| NPI | 1285256263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK AARON WHITLOCK Owner/ Dentist 901-737-3606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |