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General NPI Number Information
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NPI Number | 1821819558
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Entity Type | Organization
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Legal Business Name | WRH SERENITY DENTAL GENERAL PARTNERSHIP
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 1030 W MAIN ST
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City | LEBANON
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State | TN
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Zip | 37087-3345
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Country | US
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Telephone | 615-444-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 4251 LEBANON ROAD
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City | HERMITAGE
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State | TN
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Zip | 37076
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Country | US
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Telephone | 615-889-5545
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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. JOSEPH ROGERS
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Credential | DDS
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Telephone | 615-973-2002
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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 |
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License Number State |
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