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General NPI Number Information
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NPI Number | 1659269553
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Entity Type | Organization
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Legal Business Name | EAST NASHVILLE AESTHETIC DENTISTRY PLLC
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 1225 N LOCUST AVE
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City | LAWRENCEBURG
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State | TN
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Zip | 38464-2710
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Country | US
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Telephone | 931-762-1225
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 N LOCUST AVE
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City | LAWRENCEBURG
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State | TN
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Zip | 38464-2710
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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 | CEO / DOCTOR
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Name | SKYLOR MORTON
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Credential |
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Telephone | 931-308-4292
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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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