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General NPI Number Information
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NPI Number | 1326914136
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Entity Type | Organization
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Legal Business Name | LIFE DENTAL TENNESSEE PLLC
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 105 HEADY DR
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City | NASHVILLE
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State | TN
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Zip | 37205-4403
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Country | US
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Telephone | 615-352-6684
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Fax |
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Provider Business Mailing Address
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Address Line | 105 HEADY DR
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City | NASHVILLE
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State | TN
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Zip | 37205-4403
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Country | US
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Telephone | 615-352-6684
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | LAUREN S DAIGNEAULT
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Credential |
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Telephone | 662-550-2310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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