Individual
WILLIAM JOHN AXTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 SIGNATURE PL, LEBANON, TN 37087-3376
(270) 977-3112
Mailing address
500 LAKETOWER DR UNIT 40, LEXINGTON, KY 40502-2677
(270) 977-3112
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12128
TN
Other
Enumeration date
02/24/2021
Last updated
04/26/2023
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