| NPI | 1548344880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M FOGO President/Dentis 423-899-1948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 3448) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 778) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |