| Champion Dentistry, Llc | |
|
322 N Maple St Lebanon TN 37087-2706 | |
| (615) 606-2544 | |
| (888) 752-1480 |
| Full Name | Champion Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 322 N Maple St, Lebanon, Tennessee |
| Authorized Official Name and Position | Derrick Champion (OWNER) |
| Authorized Official Contact | 6155547401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Champion Dentistry, Llc 322 N Maple St Lebanon TN 37087-2706 Ph: (615) 606-2544 | Champion Dentistry, Llc 322 N Maple St Lebanon TN 37087-2706 Ph: (615) 606-2544 |
| NPI Number | 1053946525 |
|---|---|
| Provider Enumeration Date | 03/05/2020 |
| Last Update Date | 03/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053946525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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