| NPI | 1497908354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY L WILSON CEO/Pediatric Dentist 901-759-0970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 8557) |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2008-10-23 |