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General NPI Number Information
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NPI Number | 1811168479
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Entity Type | Organization
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Legal Business Name | DR. VANVRANKEN & ASSOCIATES
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 1958 N JACKSON ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-2204
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Country | US
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Telephone | 931-454-0001
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Fax | 931-454-0973
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Provider Business Mailing Address
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Address Line | 1958 N JACKSON ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-2204
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Country | US
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Telephone | 931-454-0001
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Fax | 931-454-0973
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Authorized Official
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Title or Position | OFFICE MANAGER/HYGIENIST
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Name | MRS. LAVENA FAYE PEAVYHOUSE
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Credential | CDA, RDH, MPH
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Telephone | 931-454-0001
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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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