# LEWISBURG SMILE STUDIO

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

## Provider details

- **NPI number:** 1003669912
- **Authorized official:** DR. RAYMOND C BRANCH DMD (OWNER)
- **Authorized official phone:** (615) 418-9021

## Contact information

- **Practice address:** 302 W CHURCH ST, LEWISBURG, TN 37091-2730
- **Practice address phone:** (931) 359-6154
- **Mailing address:** 1508 HIGHWAY 64 W, SHELBYVILLE, TN 37160-6315
- **Mailing address phone:** (615) 418-9021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/10/2024
- **Last updated:** 04/10/2024