NPI | 1376695304 |
---|---|
Entity Type | Organization |
Authorized Contact | D KEVIN HAYES President 931-526-1614 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN TN4687) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN TN4669) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2020-08-22 |