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Organization
CD TENNESSEE DENTAL, P.C.
Active
Organization
CD TENNESSEE DENTAL, P.C.
Active
Other names
Smile Solutions of Goodlettsville
Organization subpart
No
Provider details
NPI number
Authorized official
TY JUSTICE (DIRECTOR OF CREDENTIALING)
(513) 808-4984
Entity
Organization
Contact information
Practice address
3050 BUSINESS PARK CIR STE 202, GOODLETTSVILLE, TN 37072-3588
(615) 859-3700
(615) 859-6222
Mailing address
9825 KENWOOD RD STE 200, BLUE ASH, OH 45242-6252
(513) 808-4984
(513) 448-0511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
NULL
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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