Healthcare Provider Details

I. General information

NPI: 1689016511
Provider Name (Legal Business Name): ANDERSON ORTHODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4219 HILLSBORO RD STE 103
NASHVILLE TN
37215-3316
US

IV. Provider business mailing address

4219 HILLSBORO RD STE 103
NASHVILLE TN
37215-3316
US

V. Phone/Fax

Practice location:
  • Phone: 615-297-6997
  • Fax:
Mailing address:
  • Phone: 615-297-6997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number5288
License Number StateTN

VIII. Authorized Official

Name: DR. ARTHUR N ANDERSON III
Title or Position: OWNER
Credential: DMD MS
Phone: 615-297-6997