Organization
TENNESSEE DENTAL PROFESSIONALS PC
Active
Parent organization
TENNESSEE DENTAL PROFESSIONALS PC
Other names
White House Family Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
TENNESSEE DENTAL PROFESSIONALS PC
Authorized official
JASMINE REARDON (CREDENTIALING COORDINATOR)
(217) 540-8330
Entity
Organization
Contact information
Practice address
301 WHITE HOUSE CROSSING WAY, STE. B, WHITE HOUSE, TN 37188-1400
(855) 233-0431
Mailing address
301 WHITE HOUSE CROSSING WAY, STE. B, WHITE HOUSE, TN 37188-1400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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