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General NPI Number Information
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NPI Number | 1336154996
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Entity Type | Organization
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Legal Business Name | MURFREESBORO ORAL SURGERY
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1120 DOW ST
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City | MURFREESBORO
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State | TN
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Zip | 37130-2486
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Country | US
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Telephone | 615-890-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 DOW ST
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City | MURFREESBORO
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State | TN
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Zip | 37130-2486
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MELISSA HAMMOND
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Credential |
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Telephone | 615-890-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS7232
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License Number State | TN
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