| NPI | 1760896682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J OWENS Owner/President 865-984-7311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 8366) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |