Organization
TENNESSEE DENTAL PROFESSIONALS PC
Active
Parent organization
TENNESSEE DENTAL PROFESSIONALS PC
Other names
Lebanon Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
TENNESSEE DENTAL PROFESSIONALS PC
Authorized official
ALLISON VARNER (CREDENTIALING COORDINATOR)
(217) 540-6077
Entity
Organization
Contact information
Practice address
1715 W MAIN ST, LEBANON, TN 37087-3153
(615) 547-3597
Mailing address
1715 W MAIN ST, LEBANON, TN 37087-3153
(615) 547-3597
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9923
TN
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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