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Organization
SOUTHEASTERN DENTAL OF MT JULIET PLLC
Active
Organization
SOUTHEASTERN DENTAL OF MT JULIET PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE METCALF (PRACTICE ADMINISTRATOR)
(615) 568-3258
Entity
Organization
Contact information
Practice address
631 S MOUNT JULIET RD, MT JULIET, TN 37122-6319
(615) 754-6677
(615) 773-5002
Mailing address
631 S MOUNT JULIET RD, MT JULIET, TN 37122-6319
(615) 754-6677
(615) 773-5002
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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