| NPI | 1538313598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK H WEBB Owner 423-968-5112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN DS3188) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS8042) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |