# DENTISTRY AND FASTBRACES PC

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

## Provider details

- **NPI number:** 1528057254
- **Authorized official:** DR. S ADELE DOHERTY DDS MPH (CEO PRESIDENT)
- **Authorized official phone:** (615) 851-4744

## Contact information

- **Practice address:** 107 NEW BRICK CHURCH PIKE, SUITE C, GOODLETTSVILLE, TN 37072-1545
- **Practice address phone:** (615) 851-4744
- **Mailing address:** 107 NEW BRICK CHURCH PIKE, SUITE C, GOODLETTSVILLE, TN 37072-1545
- **Mailing address phone:** (615) 851-4744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 4679 | TN | Yes |

## Other

- **Enumeration date:** 10/15/2005
- **Last updated:** 02/12/2015