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General NPI Number Information
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NPI Number | 1518060524
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Entity Type | Organization
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Legal Business Name | MARYLAND FARMS FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5111 MARYLAND WAY SUITE 306
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City | BRENTWOOD
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State | TN
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Zip | 37027-7513
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Country | US
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Telephone | 615-373-8001
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Fax | 615-371-9589
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Provider Business Mailing Address
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Address Line | 5111 MARYLAND WAY SUITE 306
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City | BRENTWOOD
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State | TN
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Zip | 37027-7513
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Country | US
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Telephone | 615-373-8001
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Fax | 615-371-9589
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES N BURTON
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Credential | DDS
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Telephone | 615-373-8001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7641
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8370
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License Number State | TN
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