| NPI | 1588831275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY R HORN-BLAKE Owner/Doctor 423-283-8830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8728) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |