| NPI | 1518092915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE B FLYNN Vice President 423-893-0557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TN 7851) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |