| NPI | 1437706041 |
|---|---|
| Doing Business As | DENTISTS OF EAST BRAINERD |
| Entity Type | Organization |
| Authorized Contact | TANISHA JACKSON General Dentist/Owner 423-800-5991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |