| NPI | 1619092152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILTON KEITH ELLIS Doctor 423-434-1370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS007966) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN DS004187) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |