| NPI | 1467567412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARTLEY LYNN FORD Dentist/President 423-239-8021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN DS-00004556) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |