| NPI | 1730266594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DAVID HICKS Owner Doctor 865-777-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN D7653) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-06-25 |