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General NPI Number Information
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NPI Number | 1154407906
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Entity Type | Organization
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Legal Business Name | CORNERSTONE ORAL HEALTH CARE PC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 404 WELSHWOOD DRIVE SUITE A
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City | NASHVILLE
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State | TN
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Zip | 37211
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Country | US
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Telephone | 615-333-3382
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Fax | 615-832-1293
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Provider Business Mailing Address
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Address Line | 404 WELSHWOOD DRIVE SUITE A
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City | NASHVILLE
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State | TN
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Zip | 37211
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Country | US
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Telephone | 615-333-3382
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Fax | 615-832-1293
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Authorized Official
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Title or Position | DENTIST PRESIDENT OF CORPORATION
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Name | B ALICIA GRIFFIN
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Credential | DDS
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Telephone | 615-333-3382
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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 | DS-4440
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License Number State | TN
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