MEDICARE: DR. CHANDLER ANN PETTY COLE DDS

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	122300000X	Dentist	12226	TN

General Provider Information

NPI Number	:	1538853387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHANDLER ANN PETTY COLE DDS

Provider Business Mailing Address
First Line	:	8916 MACAULEY LN
Second Line	:
City	:	NOLENSVILLE
State	:	TN
Zip	:	37135-4013
Country	:	US
Telephone Number	:	615-636-3782
Fax Number	:

Provider Business Practice Location Address
First Line	:	4020 HUGHES XING
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-1469
Country	:	US
Telephone Number	:	615-435-3274
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/05/2023

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