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General NPI Number Information
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NPI Number | 1386323822
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Entity Type | Organization
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Legal Business Name | SUMMIT FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 3786 CENTRAL PIKE STE 100
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City | HERMITAGE
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State | TN
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Zip | 37076-3498
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Country | US
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Telephone | 615-889-3609
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 LONGPORT LN
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City | THOMPSONS STATION
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State | TN
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Zip | 37179-6800
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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 | OWNER
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Name | DR. CHRISTIAN BROWN
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Credential |
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Telephone | 801-808-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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