| NPI | 1356891675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL D MORRELL Owner 901-491-0971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TN 9030) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2017-02-01 |