| NPI | 1730636903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY MARTIN Dental Officer 901-734-3785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN05164) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2016-09-06 |