| NPI | 1447627914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CEANN GERRITY Office Manager 865-522-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 8203) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 9607) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2021-08-26 |