| NPI | 1497040901 |
|---|---|
| Former Legal Business Name | CEDAR GROVE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DEE NORTHCUTT Manager 615-220-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 7885) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2011-06-13 |