| NPI | 1336459791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN FOSTER Practice Admin/Regional Director Op 615-498-4323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 8569) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |