# HENDERSONVILLE IMPERIAL DENTAL CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003486267
- **Authorized official:** MRS. SAMANTHA JO WENCE DDS (DOCTOR)
- **Authorized official phone:** (615) 822-0833

## Contact information

- **Practice address:** 537 E. MAIN ST., HENDERSONVILLE, TN 37075
- **Practice address phone:** (615) 822-0833
- **Practice address fax:** (615) 590-7943
- **Mailing address:** 107 IMPERIAL BLVD STE 1, HENDERSONVILLE, TN 37075-3492
- **Mailing address phone:** (615) 822-0833
- **Mailing address fax:** (615) 590-7943

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2021
- **Last updated:** 08/30/2024