| NPI | 1871916668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE BODFORD MALONE Pediatric Dentist 865-766-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN 9031) |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2014-06-07 |