Individual
DR. IRA LEE SIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1195 OLD HICKORY BLVD, STE. 205, BRENTWOOD, TN 37027-4239
(615) 269-5223
(615) 269-6384
Mailing address
1195 OLD HICKORY BLVD, STE. 205, BRENTWOOD, TN 37027-4239
(615) 269-5223
(615) 269-6384
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS3767
TN
Other
Enumeration date
01/17/2006
Last updated
03/04/2014
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