| NPI | 1497318471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARSHALL JEWETT Owner 423-384-2240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |