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Organization
PROVENCE AND HALEY, PC
Active
Organization
PROVENCE AND HALEY, PC
Active
Other names
Tennessee Oral & Maxillofacial Surgeons
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MINA H HARRIS (OFFICE MANAGER)
(615) 419-1943
Entity
Organization
Contact information
Practice address
4322 HARDING PIKE, SUITE 201, NASHVILLE, TN 37205-2490
(615) 829-7000
(615) 829-7001
Mailing address
4322 HARDING PIKE, SUITE 201, NASHVILLE, TN 37205-2490
(615) 829-7000
(615) 829-7001
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS4607
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS7219
TN
Other
Enumeration date
05/18/2009
Last updated
05/18/2009
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