# COOPER, PROVENCE & HALEY, PC

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

## Provider details

- **NPI number:** 1851412811
- **Authorized official:** DR. SPENCER A HALEY DDS (VICE PRESIDENT)
- **Authorized official phone:** (615) 320-1392

## Contact information

- **Practice address:** 207 23RD AVE N, NASHVILLE, TN 37203-1501
- **Practice address phone:** (615) 320-1392
- **Practice address fax:** (615) 329-4245
- **Mailing address:** 502 E COLLEGE ST, DICKSON, TN 37055-2016
- **Mailing address phone:** (615) 446-9669
- **Mailing address fax:** (615) 446-9661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS3032 | TN | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS4607 | TN | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS7219 | TN | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 05/19/2008