| NPI | 1336351451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA BOATMAN Business Manager 865-691-0995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS7986) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2009-01-06 |