| NPI | 1295593457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN RICARDO DANIEL Owner 615-830-2176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-04-16 |