# PROMISE DENTAL

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

## Provider details

- **NPI number:** 1508292269
- **Authorized official:** DR. KELLY DIANE BUSH (DOCTOR'S WIFE)
- **Authorized official phone:** (615) 401-1103

## Contact information

- **Practice address:** 2908 SIDCO DR, NASHVILLE, TN 37204-3759
- **Practice address phone:** (615) 401-1103
- **Practice address fax:** (615) 678-4381
- **Mailing address:** 2908 SIDCO DR, NASHVILLE, TN 37204-3759
- **Mailing address phone:** (615) 401-1103
- **Mailing address fax:** (615) 678-4381

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS3134 | TN | Yes |

## Other

- **Enumeration date:** 09/25/2013
- **Last updated:** 09/25/2013