| NPI | 1790881233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM BRADSHAW Orthodontist 423-929-1126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 2005) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2020-08-22 |