Healthcare Provider Details

I. General information

NPI: 1346465689
Provider Name (Legal Business Name): MARK S. MAPPES D.D.S.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7640 HIGHWAY 70 S STE 105
NASHVILLE TN
37221-1758
US

IV. Provider business mailing address

7640 HIGHWAY 70 S STE 105
NASHVILLE TN
37221-1758
US

V. Phone/Fax

Practice location:
  • Phone: 615-662-0062
  • Fax: 615-662-8038
Mailing address:
  • Phone: 615-662-0062
  • Fax: 615-662-8038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS004808
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: