Healthcare Provider Details

I. General information

NPI: 1003088980
Provider Name (Legal Business Name): DONELSON ORAL SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 FRIST BLVD STE 300
HERMITAGE TN
37076-2057
US

IV. Provider business mailing address

5651 FRIST BLVD STE 300
HERMITAGE TN
37076-2057
US

V. Phone/Fax

Practice location:
  • Phone: 615-889-7835
  • Fax: 615-889-7837
Mailing address:
  • Phone: 615-889-7835
  • Fax: 615-889-7837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS2010
License Number StateTN

VIII. Authorized Official

Name: DR. DONALD E COX
Title or Position: OWNER
Credential: D.D.S.
Phone: 615-889-7835