NPI | 1992392708 |
---|---|
Former Legal Business Name | JAMES G SOUSOULAS DDS |
Entity Type | Organization |
Authorized Contact | MELANIE CECILE CHURINETZ President 901-692-5826 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2020-12-28 |
Last Update Date | 2020-12-28 |