NPI | 1992976997 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA R. FORTNER Administrative Assisstant 901-398-0793 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2008-03-18 |
Last Update Date | 2008-03-18 |