| NPI | 1689221152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY J RYU Dentist 901-282-8092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |