| NPI | 1689701179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PHILLIP TABOR Co Owner 615-822-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS2567) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN DS8247) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |