Healthcare Provider Details

I. General information

NPI: 1437173283
Provider Name (Legal Business Name): DANIEL ERIC OXFORD D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5518 OLD HICKORY BLVD STE A
HERMITAGE TN
37076-2584
US

IV. Provider business mailing address

5518 OLD HICKORY BLVD STE A
HERMITAGE TN
37076-2584
US

V. Phone/Fax

Practice location:
  • Phone: 615-294-8684
  • Fax: 615-889-4334
Mailing address:
  • Phone: 615-294-8684
  • Fax: 615-889-4334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number23098
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number8365
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: