| NPI | 1861971095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WUNDERLICH RACHELS Owner 615-804-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN DS0000009706) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |