| Dental Spa Pllc | |
|
125 Enon Springs Rd E Smyrna TN 37167-3032 | |
| (615) 459-2579 | |
| Not Available |
| Full Name | Dental Spa Pllc |
|---|---|
| Speciality | Dentist |
| Location | 125 Enon Springs Rd E, Smyrna, Tennessee |
| Authorized Official Name and Position | Tracie Battle (DENTIST) |
| Authorized Official Contact | 6154592579 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Spa Pllc Po Box 2623 Brentwood TN 37024-2623 Ph: () - | Dental Spa Pllc 125 Enon Springs Rd E Smyrna TN 37167-3032 Ph: (615) 459-2579 |
| NPI Number | 1790189249 |
|---|---|
| Provider Enumeration Date | 10/13/2014 |
| Last Update Date | 10/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790189249 | NPI | - | NPPES |
| 12454814 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8012 (Tennessee) | Primary |
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