Healthcare Provider Details

I. General information

NPI: 1437109956
Provider Name (Legal Business Name): DAVID ALLEN MOTT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 06/16/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 DR. D.B. TODD JR. BLVD
NASHVILLE TN
37208
US

IV. Provider business mailing address

1005 DR. D.B. TODD BLVD
NASHVILLE TN
37208
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-6207
  • Fax:
Mailing address:
  • Phone: 808-799-6027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10764
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: