| NPI | 1487782652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGHTON W WOOD Owner 423-392-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TN 3117) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2009-09-10 |