Healthcare Provider Details

I. General information

NPI: 1114181807
Provider Name (Legal Business Name): GERALD CLAY SPARROW DDS, MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4027 HILLSBORO RD SUITE 805
NASHVILLE TN
37215
US

IV. Provider business mailing address

4027 HILLSBORO RD SUITE 805
NASHVILLE TN
37215
US

V. Phone/Fax

Practice location:
  • Phone: 615-383-4455
  • Fax: 615-383-4032
Mailing address:
  • Phone: 615-383-4455
  • Fax: 615-383-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number7971
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: