| NPI | 1912556895 |
|---|---|
| Doing Business As | PEDIATRIC DENTAL CLINIC AT LEBONHEUR |
| Entity Type | Organization |
| Authorized Contact | ANTHONY A FERRARA Sr. Vice Chancellor/ Chief Financia 901-448-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2020-02-13 |