MEDICARE: CAROL MONTEE, DMD, LLC

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	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1154932549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROL MONTEE, DMD, LLC

Provider Business Mailing Address
First Line	:	3012 LONGFORD DR STE 1
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-6151
Country	:	US
Telephone Number	:	615-302-0281
Fax Number	:

Provider Business Practice Location Address
First Line	:	3012 LONGFORD DR STE 1
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-6151
Country	:	US
Telephone Number	:	615-302-0281
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL MONTEE
Credential	:	DMD
Telephone Number	:	615-302-0281

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	08/11/2020

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