| NPI | 1306927017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY F. THOMPSON Administrator 865-544-1711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 3265) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TN 3265) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |