MEDICARE: DR. CHARLES DONALD ALBURY JR. D.M.D.

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)	DS3037	TN

General Provider Information

NPI Number	:	1932101367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES DONALD ALBURY JR. D.M.D.

Provider Business Mailing Address
First Line	:	7533 OAK HAVEN TRCE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-3500
Country	:	US
Telephone Number	:	615-948-3096
Fax Number	:	615-356-2134

Provider Business Practice Location Address
First Line	:	1005 DR DB TODD BLVD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37208
Country	:	US
Telephone Number	:	615-327-6180
Fax Number	:	615-327-6508

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	10/24/2013

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