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Organization
BIG RIDGE FAMILY AND COSMETIC DENTISTRY, PLLC
Active
Organization
BIG RIDGE FAMILY AND COSMETIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA VERSTRAT DDS (MANAGING MEMBER)
(423) 877-1334
Entity
Organization
Contact information
Practice address
5606 HIGHWAY 153, HIXSON, TN 37343-3725
(423) 877-1334
Mailing address
5606 HIGHWAY 153, HIXSON, TN 37343-3725
(423) 877-1334
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
TN
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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