| Iroquois Family Dentistry | |
|
5115 Harding Pike Ste 101 Nashville TN 37205-2721 | |
| (615) 298-2040 | |
| (615) 777-2041 |
| Full Name | Iroquois Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5115 Harding Pike Ste 101, Nashville, Tennessee |
| Authorized Official Name and Position | Maryelisa Stack (OFFICE MANAGER) |
| Authorized Official Contact | 6152982040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iroquois Family Dentistry 5115 Harding Pike Ste 101 Nashville TN 37205-2721 Ph: (615) 298-2040 | Iroquois Family Dentistry 5115 Harding Pike Ste 101 Nashville TN 37205-2721 Ph: (615) 298-2040 |
| NPI Number | 1992717573 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 01/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992717573 | NPI | - | NPPES |
| 11260 | Other | TN | DENTAL LICENSE |
| 5014 | Other | TN | DENTAL LICENSE |
| 8993 | Other | TN | DENTAL LICENSE |
| 11000 | Other | TN | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2655 (Tennessee) | Primary |
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