| NPI | 1366614588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENEAN RESHAY CARR Dentist 731-253-9091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TN 8178) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |