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NPI Code Detail

MEDICARE: STONECREST FAMILY DENTAL PLLC

MEDICARE: STONECREST FAMILY DENTAL 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
11223G0001XGeneral Practice Dentistry
2261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1447052303
Entity Type Code : Organization
Provider Name (Legal Business Name) : STONECREST FAMILY DENTAL PLLC
Provider Business Mailing Address
First Line : 3786 CENTRAL PIKE STE 100
Second Line :
City : HERMITAGE
State : TN
Zip : 37076-3498
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1730 LEE VICTORY PKWY
Second Line :
City : SMYRNA
State : TN
Zip : 37167-6674
Country : US
Telephone Number : 801-808-8241
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CHRISTIAN BROWN
Credential :
Telephone Number : 801-808-8241
Provider Enumeration Date : 03/24/2025
Last Update Date : 04/14/2025

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Directions to “STONECREST FAMILY DENTAL PLLC ” Practice Location

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