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General NPI Number Information
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NPI Number | 1437741014
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Entity Type | Organization
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Legal Business Name | BRENTWOOD DENTAL ASSOCIATES, PPLC
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Dates
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Enumeration Date | 02/05/2021
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 6716 NOLENSVILLE RD STE 120
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City | BRENTWOOD
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State | TN
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Zip | 37027-8864
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Country | US
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Telephone | 157-305-5666
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Fax | 615-386-9032
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Provider Business Mailing Address
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Address Line | 4205 HILLSBORO PIKE STE 106
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City | NASHVILLE
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State | TN
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Zip | 37215-3339
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Country | US
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Telephone | 615-730-5566
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Fax | 615-386-9032
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN M O'NEILL
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Credential | DMD
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Telephone | 615-504-5499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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