| NPI | 1306488622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL LYNN GOINGS COO 615-478-7166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2019-10-09 |