MEDICARE: WESTMORELAND FAMILY DENTAL, INC.

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	1223G0001X	General Practice Dentistry	8643	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811130537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTMORELAND FAMILY DENTAL, INC.

Provider Business Mailing Address
First Line	:	PO BOX 367
Second Line	:
City	:	WESTMORELAND
State	:	TN
Zip	:	37186-0367
Country	:	US
Telephone Number	:	615-644-7000
Fax Number	:	615-644-7009

Provider Business Practice Location Address
First Line	:	1032 PLEASANT GROVE RD
Second Line	:
City	:	WESTMORELAND
State	:	TN
Zip	:	37186-2139
Country	:	US
Telephone Number	:	615-644-7000
Fax Number	:	615-644-7009

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. TONIA-MARIE PORTER
Credential	:	D.D.S.
Telephone Number	:	615-445-9296

Provider Enumeration Date	:	04/10/2009
Last Update Date	:	04/10/2009

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Directions to “WESTMORELAND FAMILY DENTAL, INC. ” Practice Location

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