| NPI | 1568952505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA PHILLIPS Owner 865-859-0355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 9446) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2018-05-15 |