| NPI | 1497269617 |
|---|---|
| Doing Business As | A FANCY CHEEZE DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHALAURENCE FURLOW COO 615-554-7422 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QC1800X |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-11-27 |