| NPI | 1801215827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE S CALLAHAN Office Manager 423-282-1030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 8138) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 9466) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2014-04-08 |