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General NPI Number Information
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NPI Number | 1194881672
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Entity Type | Organization
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Legal Business Name | S & K DENTAL AFFILIATES, PC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4761 ANDREW JACKSON PKWY
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City | HERMITAGE
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State | TN
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Zip | 37076-1354
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Country | US
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Telephone | 615-885-3525
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Fax | 615-885-9767
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Provider Business Mailing Address
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Address Line | 4761 ANDREW JACKSON PKWY
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City | HERMITAGE
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State | TN
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Zip | 37076-1354
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Country | US
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Telephone | 615-885-3525
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Fax | 615-885-9767
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MICHELLE STAINBACK
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Credential |
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Telephone | 615-885-3525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS7729
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License Number State | TN
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