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General NPI Number Information
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NPI Number | 1811349913
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Entity Type | Individual
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Provider Name | STEPHEN WYLIE MERRILL DMD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 10 BURTON HILLS BLVD
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City | NASHVILLE
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State | TN
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Zip | 37215-6105
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Country | US
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Telephone | 615-263-3854
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Fax | 615-565-9981
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Provider Business Mailing Address
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Address Line | 3317 COUNTRY CLUB DR
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City | LYNN HAVEN
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State | FL
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Zip | 32444-5130
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Country | US
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Telephone | 850-832-0857
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN10576
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30022972
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS4308
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License Number State | TN
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