| NPI | 1417033804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDRICO ALBERT DIXON President 865-584-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS7270) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2011-12-13 |