| NPI | 1881865509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA ANDRE ROUSE Owner/ Dentist 615-321-0922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 4670) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 4464) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-03-24 |