Healthcare Provider Details

I. General information

NPI: 1104170547
Provider Name (Legal Business Name): ORAL SURGERY SPECIALISTS OF BRENTWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7004 MOORES LN
BRENTWOOD TN
37027-2905
US

IV. Provider business mailing address

360 COOL SPRINGS BLVD SUITE 102
FRANKLIN TN
37067-7215
US

V. Phone/Fax

Practice location:
  • Phone: 615-771-3535
  • Fax: 615-771-1991
Mailing address:
  • Phone: 615-771-3535
  • Fax: 615-771-1991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateTN

VIII. Authorized Official

Name: DR. ADAM S PITTS
Title or Position: ORAL SURGEON
Credential: M.D.
Phone: 615-771-3535