| NPI | 1659996320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI A. HANCOCK Office Coordinator 865-687-9412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-09 |