| NPI | 1851756423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAYNNE SELLERS Office Manager 865-691-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 9858) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |