| NPI | 1740510775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY W WILKINSON Dentist 901-761-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: TN DS005140) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2010-01-14 |