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Organization
PROVIDENCE DENTAL CARE, INC.
Active
Organization
PROVIDENCE DENTAL CARE, INC.
Active
Other names
LaFever Enterprises, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY WAYNE LAFEVER D.D.S (PRESIDENT)
(615) 758-6800
Entity
Organization
Contact information
Practice address
684 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3323
(615) 758-6800
(615) 758-8419
Mailing address
684 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3323
(615) 758-6800
(615) 758-8419
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS0000004058
TN
Other
Enumeration date
09/01/2006
Last updated
01/05/2017
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