| NPI | 1760779268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY WATSON Administrative Assistant 865-429-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN DS002876) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2011-07-05 |