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General NPI Number Information
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NPI Number | 1811130537
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Entity Type | Organization
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Legal Business Name | WESTMORELAND FAMILY DENTAL, INC.
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 1032 PLEASANT GROVE RD
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City | WESTMORELAND
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State | TN
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Zip | 37186-2139
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Country | US
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Telephone | 615-644-7000
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Fax | 615-644-7009
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Provider Business Mailing Address
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Address Line | PO BOX 367
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City | WESTMORELAND
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State | TN
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Zip | 37186-0367
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Country | US
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Telephone | 615-644-7000
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Fax | 615-644-7009
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. TONIA-MARIE PORTER
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Credential | D.D.S.
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Telephone | 615-445-9296
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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 | 8643
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License Number State | TN
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