| NPI | 1619182292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T MANN General 931-363-8992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 3808) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 3808) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-17 |