Organization
NORTHCREEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED BEAZLEY (DENTIST)
(615) 426-6147
Entity
Organization
Contact information
Practice address
318 NORTHCREEK BLVD, SUITE 400, GOODLETTSVILLE, TN 37072-1934
(615) 239-4000
(615) 239-4004
Mailing address
318 NORTHCREEK BLVD, SUITE 400, GOODLETTSVILLE, TN 37072-1934
(615) 239-4000
(615) 239-4004
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4638
TN
Other
Enumeration date
08/10/2015
Last updated
08/18/2015
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