Healthcare Provider Details

I. General information

NPI: 1033902374
Provider Name (Legal Business Name): DREAM TEAM FAMILY DENTISTRY AND ORAL SURGERY MURFREESBORO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 W NORTHFIELD BLVD STE 10&11
MURFREESBORO TN
37129-1427
US

IV. Provider business mailing address

1535 W NORTHFIELD BLVD STE 10&11
MURFREESBORO TN
37129-1427
US

V. Phone/Fax

Practice location:
  • Phone: 615-895-3232
  • Fax: 615-893-3224
Mailing address:
  • Phone: 615-895-3232
  • Fax: 615-893-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: JAMIE DRISCOLL
Title or Position: MANAGER
Credential:
Phone: 675-895-3232