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Organization
NOTHSIDE DENTAL CENTER, PA
Active
Organization
NOTHSIDE DENTAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK H HAMPSON D.D.S. (SECRETARY/TREASURER)
(731) 668-7916
Entity
Organization
Contact information
Practice address
3067 N HIGHLAND AVE, JACKSON, TN 38305-3411
(731) 668-7916
(731) 668-9544
Mailing address
3067 N HIGHLAND AVE, JACKSON, TN 38305-3411
(731) 668-7916
(731) 668-9544
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0149768
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
02/21/2006
Last updated
06/26/2008
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