| NPI | 1710442074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH COOPER DYER Co Owner/Orthodontist 423-622-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |