# PROVENCE AND HALEY, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Tennessee Oral & Maxillofacial Surgeons
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225263460
- **Authorized official:** MR. MINA H HARRIS (OFFICE MANAGER)
- **Authorized official phone:** (615) 419-1943

## Contact information

- **Practice address:** 4322 HARDING PIKE, SUITE 201, NASHVILLE, TN 37205-2490
- **Practice address phone:** (615) 829-7000
- **Practice address fax:** (615) 829-7001
- **Mailing address:** 4322 HARDING PIKE, SUITE 201, NASHVILLE, TN 37205-2490
- **Mailing address phone:** (615) 829-7000
- **Mailing address fax:** (615) 829-7001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS4607 | TN | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS7219 | TN | Yes |

## Other

- **Enumeration date:** 05/18/2009
- **Last updated:** 05/18/2009