| NPI | 1619162187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH LAWRENCE MCRAE Owner 901-767-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 3587) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |