| NPI | 1710062120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R WARISE Owner, CEO 615-459-3366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS005144) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |