| NPI | 1487365433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN O BLANTON Owner 901-417-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2023-10-18 |