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General NPI Number Information
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NPI Number | 1699281790
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Entity Type | Organization
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Legal Business Name | WEST END SMILES, INC
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Dates
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Enumeration Date | 12/27/2017
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 1800 W END AVE STE 102
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City | NASHVILLE
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State | TN
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Zip | 37203-2506
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Country | US
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Telephone | 615-327-4904
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Fax | 615-320-5836
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Provider Business Mailing Address
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Address Line | 1800 W END AVE STE 102
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City | NASHVILLE
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State | TN
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Zip | 37203-2506
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Country | US
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Telephone | 615-327-4904
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Fax | 615-320-5836
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Authorized Official
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Title or Position | DENTIST
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Name | IVANA K. HRSTIC
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Credential | DDS
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Telephone | 615-327-4904
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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 | 8146
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License Number State | TN
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