Organization
615 DENTAL
Active
Other names
Blackman Grove Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN FOSTER (PRACTICE ADMINISTRATOR)
(615) 907-4746
Entity
Organization
Contact information
Practice address
4183 FRANKLIN RD, SUITE B5, MURFREESBORO, TN 37128-4254
(615) 907-4746
(615) 907-4796
Mailing address
4183 FRANKLIN RD, SUITE B5, MURFREESBORO, TN 37128-4254
(615) 907-4746
(615) 907-4796
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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