# SOH OF TENNESSEE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOH OF TENNESSEE PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1992280648
- **Legal business name:** SOH OF TENNESSEE PLLC
- **Authorized official:** RAY WEBER (REGIONAL SUPPORT SPECIALIST)
- **Authorized official phone:** (314) 753-8154

## Contact information

- **Practice address:** 1600 WESTGATE CIR, BRENTWOOD, TN 37027-8059
- **Practice address phone:** (615) 481-4555
- **Mailing address:** 1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
- **Mailing address phone:** (636) 362-4986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/28/2018
- **Last updated:** 09/28/2026