Healthcare Provider Details

I. General information

NPI: 1053140913
Provider Name (Legal Business Name): COOL SPRINGS ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 W MCEWEN DR STE 60
FRANKLIN TN
37067-1770
US

IV. Provider business mailing address

1550 W MCEWEN DR STE 60
FRANKLIN TN
37067-1770
US

V. Phone/Fax

Practice location:
  • Phone: 615-778-1800
  • Fax:
Mailing address:
  • Phone: 615-778-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAIFALI GROVER
Title or Position: ORTHODONTIST
Credential: DMD, MS
Phone: 732-357-6858