# STATE OF TENNESSEE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MCRO Mobile Dental Unit
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720125545
- **Authorized official:** MRS. ANNETTE HALEY (REGIONAL DIRECTOR)
- **Authorized official phone:** (615) 650-7000

## Contact information

- **Practice address:** 710 HART LN, NASHVILLE, TN 37216-2627
- **Practice address phone:** (615) 650-7000
- **Practice address fax:** (615) 262-6139
- **Mailing address:** 710 HART LN, NASHVILLE, TN 37216-2627
- **Mailing address phone:** (615) 650-7000
- **Mailing address fax:** (615) 262-6139

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/31/2007
- **Last updated:** 08/28/2012