MEDICARE: NASHVILLE SMILES PLLC

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	122300000X	Dentist	9402	TN
2	122300000X	Dentist	9408	TN

General Provider Information

NPI Number	:	1053687368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASHVILLE SMILES PLLC

Provider Business Mailing Address
First Line	:	8090 HIGHWAY 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-4212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8090 HIGHWAY 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-4212
Country	:	US
Telephone Number	:	615-646-3549
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	ROBERT LITTLEJOHN
Credential	:	DMD
Telephone Number	:	615-646-3549

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	03/30/2012

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