Organization
BIG RIDGE FAMILY AND COSMETIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA VERSTRAT DDS (MANAGING MEMBER)
(423) 877-1334
Entity
Organization
Contact information
Practice address
5606 HIGHWAY 153, HIXSON, TN 37343-3725
(423) 877-1334
Mailing address
5606 HIGHWAY 153, HIXSON, TN 37343-3725
(423) 877-1334
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
TN
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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