Individual
DR. WALTER RUSSELL OWENS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
617 WOODLAND ST, NASHVILLE, TN 37206-4211
(615) 256-2321
(615) 221-9891
Mailing address
532 TURTLE CREEK DR, BRENTWOOD, TN 37027-5617
(615) 293-2957
(615) 221-9891
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3526
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5622
TENNCARE
TN
Enumeration date
08/28/2007
Last updated
08/28/2007
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