| NPI | 1568339711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Sr. Director Of Credentialing 615-678-0759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-10-22 |
| Last Update Date | 2025-10-22 |