# DYNAMIC DENTISTRY LLC

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

## Provider details

- **NPI number:** 1740554518
- **Authorized official:** DR. JOHN AMBURGEY III DDS (PRESIDENT)
- **Authorized official phone:** (931) 474-1329

## Contact information

- **Practice address:** 24 LIBERTY LN, MCMINNVILLE, TN 37110-3362
- **Practice address phone:** (931) 474-1329
- **Practice address fax:** (931) 474-1330
- **Mailing address:** PO BOX 191, MCMINNVILLE, TN 37111-0191
- **Mailing address phone:** (931) 474-1329
- **Mailing address fax:** (931) 474-1330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/27/2012
- **Last updated:** 05/23/2012