| NPI | 1790078988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN T BOLDEN President/Dentist 615-891-1853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN 8739) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |