| NPI | 1740430685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK A OSBORNE General Dentist 865-687-3203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN DS0000005136) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TN DS0000005028) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2008-09-29 |