Organization
CHAMPION DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK CHAMPION DDS (OWNER)
(615) 554-7401
Entity
Organization
Contact information
Practice address
322 N MAPLE ST, LEBANON, TN 37087-2706
(615) 606-2544
(888) 752-1480
Mailing address
322 N MAPLE ST, LEBANON, TN 37087-2706
(615) 606-2544
(888) 752-1480
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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