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Individual

JOSEPH ROMAN MORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
131 INDIAN LAKE BLVD STE 100, HENDERSONVILLE, TN 37075
(615) 822-8403
Mailing address
131 INDIAN LAKE BLVD STE 100, HENDERSONVILLE, TN 37075-6207
(615) 822-8403

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS0000010524
TN

Other

Enumeration date
04/08/2014
Last updated
08/15/2018
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