| NPI | 1477880490 | 
|---|---|
| Doing Business As | THREE RIVERS FAMILY DENTISTRY | 
| Entity Type | Organization | 
| Authorized Contact | MARK ALLEN CONNOLLY President 615-907-3456  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8779)  | 
| Enumeration Date | 2009-11-12 | 
| Last Update Date | 2009-11-12 |