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Organization

CREATIVE DENTISTRY P.C.

Active
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Organization

CREATIVE DENTISTRY P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUANITA ANDRE ROUSE DDS (OWNER/ DENTIST)
(615) 321-0922
Entity
Organization

Contact information

Practice address
113 23RD AVE N, NASHVILLE, TN 37203-1701
(615) 321-0922
(615) 329-9343
Mailing address
113 23RD AVE N, NASHVILLE, TN 37203-1701
(615) 321-0922
(615) 329-9343

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4670
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4464
TN

Other

Enumeration date
03/20/2008
Last updated
03/24/2008
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