MEDICARE: JUSTIN R POFF DDS, 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	261QD0000X	Dental Clinic/Center	9350	TN

General Provider Information

NPI Number	:	1699150235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUSTIN R POFF DDS, PLLC

Provider Business Mailing Address
First Line	:	7041 HIGHWAY 70 S
Second Line	:	SUITE 7
City	:	NASHVILLE
State	:	TN
Zip	:	37221-5238
Country	:	US
Telephone Number	:	615-662-2400
Fax Number	:	615-662-2423

Provider Business Practice Location Address
First Line	:	7041 HIGHWAY 70 S
Second Line	:	SUITE 7
City	:	NASHVILLE
State	:	TN
Zip	:	37221-5238
Country	:	US
Telephone Number	:	615-662-2400
Fax Number	:	615-662-2423

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUSTIN RHETT POFF
Credential	:	DDS
Telephone Number	:	615-662-2400

Provider Enumeration Date	:	07/24/2015
Last Update Date	:	07/24/2015

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