| NPI | 1558366716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT A DEBOW Dentist Orthodontist 423-247-5137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: TN DS 2129) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |