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General NPI Number Information
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NPI Number | 1730800343
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Entity Type | Organization
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Legal Business Name | TENNESSEE FAMILY DENTAL CARE- MIDTOWN PLLC
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 2106 CHARLOTTE AVE
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City | NASHVILLE
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State | TN
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Zip | 37203-1816
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Country | US
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Telephone | 615-321-2702
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Fax | 616-469-1036
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Provider Business Mailing Address
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Address Line | 2106 CHARLOTTE AVE
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City | NASHVILLE
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State | TN
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Zip | 37203-1816
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Country | US
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Telephone | 615-321-2702
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Fax | 616-469-1036
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Authorized Official
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Title or Position | HR MANAGER
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Name | AMBER BLACKBURN
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Credential |
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Telephone | 269-388-5832
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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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