| Brentwood Pediatric Dentistry, Llc | |
|
95 Seaboard Ln Suite 102 Brentwood TN 37027-3031 | |
| (615) 377-3080 | |
| (615) 377-3088 |
| Full Name | Brentwood Pediatric Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 95 Seaboard Ln, Brentwood, Tennessee |
| Authorized Official Name and Position | Ryan A Cregger (DDS/OWNER) |
| Authorized Official Contact | 6153773080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brentwood Pediatric Dentistry, Llc 95 Seaboard Ln Suite 102 Brentwood TN 37027-3031 Ph: (615) 377-3080 | Brentwood Pediatric Dentistry, Llc 95 Seaboard Ln Suite 102 Brentwood TN 37027-3031 Ph: (615) 377-3080 |
| NPI Number | 1730481540 |
|---|---|
| Provider Enumeration Date | 11/30/2010 |
| Last Update Date | 11/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730481540 | NPI | - | NPPES |
| 1509457 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DS8825 (Tennessee) | Primary |
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