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General NPI Number Information
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NPI Number | 1073990776
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Entity Type | Organization
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Legal Business Name | ERIN FAMILY DENTAL
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 4889 E MAIN ST
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City | ERIN
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State | TN
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Zip | 37061-4115
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Country | US
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Telephone | 931-289-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 4889 E MAIN ST
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City | ERIN
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State | TN
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Zip | 37061-4115
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Country | US
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Telephone | 931-289-2200
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DOUGLAS WESLEY MCMILLAN
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Credential | D.D.S.
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Telephone | 615-804-8368
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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 |
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License Number State |
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