Individual
BREA CITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1272 MARKET ST, DAYTON, TN 37321-1250
(423) 834-9900
Mailing address
161 S JACKSON ST, ATHENS, TN 37303-4710
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10085
TN
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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