| NPI | 1700428893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL DAVIS Dentist 423-899-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2023-06-21 |