Organization
HERMITAGE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRKLAND E LARSON D.D.S (DENTIST)
(615) 889-1654
Entity
Organization
Contact information
Practice address
107 BONNABROOK DR, HERMITAGE, TN 37076-1910
(615) 889-1654
(615) 316-9197
Mailing address
107 BONNABROOK DR, HERMITAGE, TN 37076-1910
(615) 889-1654
(615) 316-9197
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8202
TN
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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