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General NPI Number Information
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NPI Number | 1821549908
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Entity Type | Organization
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Legal Business Name | MURFREESBORO SMILES DENTISTRY, PC
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 125 WENDELWOOD DR STE B
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City | MURFREESBORO
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State | TN
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Zip | 37129-3746
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Country | US
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Telephone | 615-904-1585
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Fax | 615-913-4184
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Provider Business Mailing Address
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Address Line | PO BOX 920050
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City | DALLAS
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State | TX
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Zip | 75392-0050
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Country | US
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Telephone | 615-904-1585
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. JESSICA DILEO
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Credential | DMD
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Telephone | 615-904-1585
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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 |
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License Number State |
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