| NPI | 1336154202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF RYDBURG Vice President 615-373-7415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2024-04-30 |