| Childrens Dentistry Of Murfreesboro Pllc | |
|
538 Brandies Circle Suite 102 Murfreesboro TN 37128 | |
| (901) 484-3812 | |
| Not Available |
| Full Name | Childrens Dentistry Of Murfreesboro Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 538 Brandies Circle, Murfreesboro, Tennessee |
| Authorized Official Name and Position | Jack Daniel Mallette (OWNER-PROVIDER) |
| Authorized Official Contact | 9014843812 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dentistry Of Murfreesboro Pllc Po Box 331362 Murfreesboro TN 37133-1362 Ph: () - | Childrens Dentistry Of Murfreesboro Pllc 538 Brandies Circle Suite 102 Murfreesboro TN 37128 Ph: (901) 484-3812 |
| NPI Number | 1548463466 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548463466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DS8406 (Tennessee) | Primary |
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