| NPI | 1447668546 |
|---|---|
| Doing Business As | PLEASANT GROVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KIM WILSON Cred Supervisor 615-754-2295 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-01 |