| NPI | 1992717573 |
|---|---|
| Former Legal Business Name | GARY L. WALTEMATH DDS PC |
| Doing Business As | IROQUOIS DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARYELISA STACK Office Manager 615-298-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 2655) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2021-01-19 |