| NPI | 1710377577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIA MORAN Practice Administrator 615-824-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: TN 8017) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: TN 9429) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |