| NPI | 1659793495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETTIENNE R. VAN ZYL Dentist/Owner 901-457-7753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN D.S.7305) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-01-14 |