| NPI | 1679955165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP WAYNE HEAD Dentist 931-388-5627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TN 3913-170) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2015-06-22 |