| NPI | 1841317633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRIE JONAKIN RAINES President 423-877-3848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS3483) |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2013-06-18 |