Organization
SOUTHEASTERN DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE J METCALF (PRACTICE ADMINISTRATOR)
(615) 568-3258
Entity
Organization
Contact information
Practice address
117 GALLATIN PIKE N, MADISON, TN 37115-3701
(615) 868-6177
Mailing address
117 GALLATIN PIKE N, MADISON, TN 37115-3701
(615) 868-6177
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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