| NPI | 1750720108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH REED TOWNSEND Owner 865-218-9177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TN 8203) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TN 8900) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: TN 9607) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2015-02-04 |