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General NPI Number Information
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NPI Number | 1598621773
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Entity Type | Organization
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Legal Business Name | IROQUOIS DENTISTRY GENERAL PARTNERSHIP
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Dates
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Enumeration Date | 12/31/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 5115 HARDING PIKE STE 101
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City | NASHVILLE
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State | TN
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Zip | 37205-2721
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Country | US
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Telephone | 615-298-2040
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Fax | 615-777-2041
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Provider Business Mailing Address
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Address Line | 5115 HARDING PIKE STE 101
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City | NASHVILLE
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State | TN
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Zip | 37205-2721
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Country | US
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Telephone | 615-298-2040
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Fax | 615-777-2041
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARYELISA STACK
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Credential |
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Telephone | 630-292-8126
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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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