| NPI | 1467758227 |
|---|---|
| Former Legal Business Name | UNIVERSITY DENTAL ASSOC |
| Entity Type | Organization |
| Authorized Contact | TONYA LYNN LANGENBRUNNER Office Manager 423-928-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN DS3637) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2013-08-01 |