| NPI | 1760531974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA MCCALMAN Business Manager 901-754-8002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 4274 and 7089) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-12-17 |