| Maple Leaf Implant And General Dentistry, Pllc | |
|
220 N Washington Ave Cookeville TN 38501-2642 | |
| (931) 526-2613 | |
| (931) 646-0901 |
| Full Name | Maple Leaf Implant And General Dentistry, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 220 N Washington Ave, Cookeville, Tennessee |
| Authorized Official Name and Position | Jerald A Bryant (DENTIST) |
| Authorized Official Contact | 9315262613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Leaf Implant And General Dentistry, Pllc 220 N Washington Ave Cookeville TN 38501-2642 Ph: (931) 526-2613 | Maple Leaf Implant And General Dentistry, Pllc 220 N Washington Ave Cookeville TN 38501-2642 Ph: (931) 526-2613 |
| NPI Number | 1679879415 |
|---|---|
| Provider Enumeration Date | 01/26/2011 |
| Last Update Date | 02/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679879415 | NPI | - | NPPES |
| Q009025 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7879 (Tennessee) | Primary |
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