NPI | 1821164724 |
---|---|
Entity Type | Organization |
Authorized Contact | BERNELL A ROGERS Accounting Assistant Lll 901-448-4944 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2006-11-24 |
Last Update Date | 2020-08-22 |