| NPI | 1518460500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY GOVAR Front Office Manager 931-363-1564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8941) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |