| NPI | 1376206755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE V DASCH Director Of Provider Relations 615-678-0759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-10-21 |