| NPI | 1497079032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE ASHLOCK Dentist 901-681-0408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS7770) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN DS7027) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |