| Dentistry And Fastbraces Pc | |
|
107 New Brick Church Pike Suite C Goodlettsville TN 37072-1545 | |
| (615) 851-4744 | |
| Not Available |
| Full Name | Dentistry And Fastbraces Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 107 New Brick Church Pike, Goodlettsville, Tennessee |
| Authorized Official Name and Position | S Adele Doherty (CEO PRESIDENT) |
| Authorized Official Contact | 6158514744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentistry And Fastbraces Pc 107 New Brick Church Pike Suite C Goodlettsville TN 37072-1545 Ph: (615) 851-4744 | Dentistry And Fastbraces Pc 107 New Brick Church Pike Suite C Goodlettsville TN 37072-1545 Ph: (615) 851-4744 |
| NPI Number | 1528057254 |
|---|---|
| Provider Enumeration Date | 10/15/2005 |
| Last Update Date | 02/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528057254 | NPI | - | NPPES |
| 0005870 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4679 (Tennessee) | Primary |
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