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General NPI Number Information
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NPI Number | 1750098489
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Entity Type | Organization
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Legal Business Name | DALTON DENTAL STUDIO, LLC
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 100 BLUEGRASS COMMONS BLVD STE 2180
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2738
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Country | US
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Telephone | 615-570-0003
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Fax | 615-235-0061
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Provider Business Mailing Address
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Address Line | 100 BLUEGRASS COMMONS BLVD STE 2180
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2738
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Country | US
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Telephone | 615-570-0003
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Fax | 615-235-0061
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. BRIAN PATRICK DALTON
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Credential | DDS
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Telephone | 615-294-3703
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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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