| NPI | 1861159204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE ANTHONY BARE Dentist / Member / Owner 615-618-0374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2022-05-19 |