| NPI | 1689980831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALETHA M BOLDEN President/Owner 615-957-1823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: TN 8802) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2023-03-07 |