| NPI | 1902229776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN D LUCAS Orthodontist 615-383-5152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN DS7361) |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2014-01-29 |