| NPI | 1467950790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT N GENGOZIAN Marketing Director 865-206-6198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: TN 1007) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-03-17 |