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General NPI Number Information
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NPI Number | 1972023687
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Entity Type | Organization
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Legal Business Name | HILLSBORO DENTAL TN PLLC
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 06/23/2017
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Provider Practice Location Address
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Address Line | 4219 HILLSBORO PIKE STE 101
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City | NASHVILLE
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State | TN
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Zip | 37215-3309
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Country | US
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Telephone | 615-292-4479
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Fax |
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Provider Business Mailing Address
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Address Line | 110 31ST AVE N APT 505
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City | NASHVILLE
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State | TN
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Zip | 37203-1576
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. LAUREN M MEDWED
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Credential | DMD
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Telephone | 615-292-4479
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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 | 10326
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License Number State | TN
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