Healthcare Provider Details

I. General information

NPI: 1205008497
Provider Name (Legal Business Name): KAIL, GROBMYER AND LEONARD DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6058 HIGHWAY 412 S
BELLS TN
38006-3908
US

IV. Provider business mailing address

6058 HIGHWAY 412 S
BELLS TN
38006-3908
US

V. Phone/Fax

Practice location:
  • Phone: 731-663-9999
  • Fax: 731-663-0510
Mailing address:
  • Phone: 731-663-9999
  • Fax: 731-663-0510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DAWN BROWN
Title or Position: INSURANCE
Credential:
Phone: 731-663-9999