Healthcare Provider Details

I. General information

NPI: 1780622233
Provider Name (Legal Business Name): SANDRA VERLENE TRICE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 GLENGARRY DR
NASHVILLE TN
37217
US

IV. Provider business mailing address

304 GLENGARRY DR
NASHVILLE TN
37217
US

V. Phone/Fax

Practice location:
  • Phone: 615-360-1005
  • Fax: 615-360-1014
Mailing address:
  • Phone: 615-360-1005
  • Fax: 615-360-1014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS0000005228
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: