| NPI | 1861013195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN KIMSEY Patient Care Coordinator 865-381-8867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2020-06-30 |