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 |