| NPI | 1366956419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY MITCHELL STEWART Owner 901-262-0217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MS 3105-99) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |