MEDICARE: SPENCER R BIERLEIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901022699	MI
2	1223G0001X	General Practice Dentistry	10864	TN

General Provider Information

NPI Number	:	1033605597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPENCER R BIERLEIN

Provider Business Mailing Address
First Line	:	3802 MURPHY RD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-4908
Country	:	US
Telephone Number	:	989-598-7268
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 CRESTMOOR RD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2005
Country	:	US
Telephone Number	:	615-258-6709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	09/25/2018

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Directions to “ SPENCER R BIERLEIN ” Practice Location

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