| NPI | 1730630625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELYSIA PARHAM BELVA Dentist/Owner 423-580-2407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: TN 9069) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |