| NPI | 1912121872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL C WIECZOREK Dentist President Of Corporation 931-461-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS0000007411) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2011-03-25 |