| NPI | 1619064391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEWAYNE B. MCCAMISH President 423-622-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TN DS2208) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |