| NPI | 1366797748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN C. GRANGER Managing Member/Owner 615-480-5562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: DEN1000983) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |