MEDICARE: DONELSON DENTAL CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1285395715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONELSON DENTAL CENTER, PLLC

Provider Business Mailing Address
First Line	:	120 DONELSON PIKE STE 103
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-2911
Country	:	US
Telephone Number	:	615-928-2554
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 DONELSON PIKE STE 103
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-2911
Country	:	US
Telephone Number	:	615-928-2554
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL MONTEE
Credential	:	DMD
Telephone Number	:	615-302-0281

Provider Enumeration Date	:	01/06/2022
Last Update Date	:	01/06/2022

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