| NPI | 1528224565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE A MADISON Dentist/Owner 865-453-0032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN DS4122) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |