MEDICARE: DR. CATHLEEN PATRICIA COYNE DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	7339	TN

General Provider Information

NPI Number	:	1083790968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHLEEN PATRICIA COYNE DDS

Provider Business Mailing Address
First Line	:	122 COOL SPRINGS BLVD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7240
Country	:	US
Telephone Number	:	615-771-0017
Fax Number	:	615-656-2166

Provider Business Practice Location Address
First Line	:	122 COOL SPRINGS BLVD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7240
Country	:	US
Telephone Number	:	615-771-0017
Fax Number	:	615-656-2166

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/08/2007

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