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General NPI Number Information
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NPI Number | 1205795911
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Entity Type | Organization
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Legal Business Name | MAURY COUNTY ENDODONTICS
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1324 TROTWOOD AVE STE 2
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City | COLUMBIA
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State | TN
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Zip | 38401-4750
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Country | US
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Telephone | 931-388-5627
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 TROTWOOD AVE STE 2
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City | COLUMBIA
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State | TN
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Zip | 38401-4750
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Country | US
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Telephone | 931-388-5627
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | THOMAS BRIAN BOZEMAN
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Credential | 12439/TN
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Telephone | 707-529-9029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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