| NPI | 1295719516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | G STEPHEN OLLARD Owner 865-584-4641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN DS0000002088) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-08-22 |