| NPI | 1588045454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPARKLE EULLS Office Manager 901-818-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8099) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |