| NPI | 1649679002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RILEY H LUNN Dentist 423-892-5137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 1902) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 4709) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2015-11-19 |