NPI | 1992828370 |
---|---|
Entity Type | Organization |
Authorized Contact | DERRICK DISHUN PAYNE Partner Owner 901-737-8714 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS7858) |
Enumeration Date | 2007-04-09 |
Last Update Date | 2015-07-24 |