MEDICARE: COYNE-OMS, 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number	:	1578302733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COYNE-OMS, LLC

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	:	ORAL SURGEON/OWNER
Name	:	DR. CATHLEEN COYNE
Credential	:	DDS
Telephone Number	:	615-771-0017

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	05/20/2024

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