| NPI | 1386815462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA DENISE BRAXTON Dentist 901-775-0870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 7160) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |