| NPI | 1396880480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN C KOONCE President 931-684-2445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS2322) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |