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Organization
COSMETIC & FAMILY DENTISTRY
Active
Organization
COSMETIC & FAMILY DENTISTRY
Active
Other names
New Image Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIREZA ALLEN BLOURCHIAN DDS (CEO)
(615) 591-4490
Entity
Organization
Contact information
Practice address
155 COVEY DR, SUITE 300, FRANKLIN, TN 37067-5602
(615) 591-4490
Mailing address
155 COVEY DR, SUITE 300, FRANKLIN, TN 37067-5602
(615) 591-4490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS5340
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932395639
PRSONAL NPI
—
05
—
3206940
—
TN
Enumeration date
07/10/2011
Last updated
07/10/2011
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