| NPI | 1699750216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | G STEPHEN OLLARD Owner 865-453-6959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN DS0000002088) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-08-22 |