| NPI | 1780616912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY D. BREWER Dentist 423-899-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8029) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-06-13 |