| NPI | 1417185737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN CLARENCE BENNERMAN Owner 615-746-4533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN DS8190) |
| Additional Taxonomies | 2080S0012X Pediatrics, Sleep Medicine (Licence: TN MD24304) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2011-03-03 |