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General NPI Number Information
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NPI Number | 1023556941
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Entity Type | Individual
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Provider Name | SUNNY MORGEN WILLOUGHBY-MCDERMOTT DDS
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Gender | Female
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Dates
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Enumeration Date | 02/11/2017
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Last Update Date | 08/13/2023
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Provider Practice Location Address
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Address Line | 5300 HICKORY HOLLOW LN STE 107
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City | ANTIOCH
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State | TN
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Zip | 37013-5083
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Country | US
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Telephone | 615-340-6904
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Fax |
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Provider Business Mailing Address
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Address Line | 306 CHIMNEY RDG
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City | NOLENSVILLE
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State | TN
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Zip | 37135-4103
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Country | US
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Telephone | 615-364-3036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12237
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License Number State | TN
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