# NORTHCREEK DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396121612
- **Authorized official:** TED BEAZLEY (DENTIST)
- **Authorized official phone:** (615) 426-6147

## Contact information

- **Practice address:** 318 NORTHCREEK BLVD, SUITE 400, GOODLETTSVILLE, TN 37072-1934
- **Practice address phone:** (615) 239-4000
- **Practice address fax:** (615) 239-4004
- **Mailing address:** 318 NORTHCREEK BLVD, SUITE 400, GOODLETTSVILLE, TN 37072-1934
- **Mailing address phone:** (615) 239-4000
- **Mailing address fax:** (615) 239-4004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 4638 | TN | Yes |

## Other

- **Enumeration date:** 08/10/2015
- **Last updated:** 08/18/2015