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General NPI Number Information
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NPI Number | 1396563946
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Entity Type | Organization
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Legal Business Name | DENTISTRY OF LEWISBURG
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1360 S ELLINGTON PKWY
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City | LEWISBURG
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State | TN
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Zip | 37091-4324
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Country | US
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Telephone | 931-308-4292
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Fax |
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Provider Business Mailing Address
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Address Line | 20 OLD PLEASANT GROVE RD
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City | MOUNT JULIET
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State | TN
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Zip | 37122-3879
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Country | US
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Telephone | 615-970-2300
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Fax |
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Authorized Official
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Title or Position | CEO/DOCTOR
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Name | DR. SKYLOR MORTON
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Credential | DDS
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Telephone | 615-970-2300
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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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