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Individual

BRIAN DANIEL FANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1605 NASHVILLE HWY, SUITE 100, COLUMBIA, TN 38401-2071
(931) 381-6880
(931) 381-3093
Mailing address
1605 NASHVILLE HWY, SUITE 100, COLUMBIA, TN 38401-2071
(931) 381-6880
(931) 381-3093

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0000007881
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016483
TN
Enumeration date
10/23/2006
Last updated
05/24/2016
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