| NPI | 1730457326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENDY ALLEN Credentialing 615-930-3718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 9204) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2019-10-07 |