| NPI | 1669750717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODRIC LEDELL MILLER President/Dentist 9013-737-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN DS0000007946) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2011-07-22 |