# HICKORY PLAZA DENTAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hickory Plaza Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225701493
- **Authorized official:** BRYAN LEE (DDS)
- **Authorized official phone:** (615) 988-5309

## Contact information

- **Practice address:** 5705 NOLENSVILLE PIKE STE A, NASHVILLE, TN 37211-6423
- **Practice address phone:** (615) 988-5309
- **Practice address fax:** (615) 393-6719
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (303) 952-0892

## Taxonomy

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

## Other

- **Enumeration date:** 07/26/2021
- **Last updated:** 07/26/2021