| NPI | 1689789067 |
|---|---|
| Doing Business As | BACK TO BASICS DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | RHONDA JEANENE MOON Insur COO Rdinator 931-645-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 4722) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2008-07-28 |