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General NPI Number Information
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NPI Number | 1326301292
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Entity Type | Organization
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Legal Business Name | MIDDLE TENNESSEE ORAL SLEEP THERAPY LLC
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Dates
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Enumeration Date | 06/16/2012
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 4205 HILLSBORO PIKE SUITE 105
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City | NASHVILLE
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State | TN
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Zip | 37215-3336
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Country | US
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Telephone | 615-269-4209
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Fax | 615-383-1998
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Provider Business Mailing Address
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Address Line | 4219 HILLSBORO PIKE SUITE 102
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City | NASHVILLE
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State | TN
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Zip | 37215-3328
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Country | US
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Telephone | 615-269-4209
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Fax | 615-383-1998
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN DEVINE
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Credential | D.D.S.
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Telephone | 61526942909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | DS5009
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License Number State | TN
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