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NPI Code Detail

MEDICARE: SYLVAN PARK SMILES DENTISTRY, PC

MEDICARE: SYLVAN PARK SMILES DENTISTRY, PC
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
1122300000XDentist

General Provider Information

NPI Number : 1831749027
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYLVAN PARK SMILES DENTISTRY, PC
Provider Business Mailing Address
First Line : PO BOX 920050
Second Line :
City : DALLAS
State : TX
Zip : 75392-0050
Country : US
Telephone Number : 714-845-8500
Fax Number : 303-952-0892
Provider Business Practice Location Address
First Line : 4502 CHARLOTTE AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-3610
Country : US
Telephone Number : 615-647-8421
Fax Number : 615-686-2494
Authorized Official
Title or Position : OWNER
Name : DR. MACY C BEGLEY
Credential : DDS
Telephone Number : 615-547-8421
Provider Enumeration Date : 09/19/2019
Last Update Date : 03/09/2022

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