| NPI | 1538679097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL RUCKER Owner 615-557-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 8466) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |