Healthcare Provider Details

I. General information

NPI: 1821819558
Provider Name (Legal Business Name): WRH SERENITY DENTAL GENERAL PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 10/24/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 W MAIN ST
LEBANON TN
37087-3345
US

IV. Provider business mailing address

4251 LEBANON ROAD
HERMITAGE TN
37076
US

V. Phone/Fax

Practice location:
  • Phone: 615-444-3932
  • Fax:
Mailing address:
  • Phone: 615-889-5545
  • Fax:

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: DR. JOSEPH ROGERS
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 615-973-2002