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Organization

PROVIDENCE DENTAL CARE, INC.

Active
Other names
LaFever Enterprises, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LARRY WAYNE LAFEVER D.D.S (PRESIDENT)
(615) 758-6800
Entity
Organization

Contact information

Practice address
684 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3323
(615) 758-6800
(615) 758-8419
Mailing address
684 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3323
(615) 758-6800
(615) 758-8419

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS0000004058
TN

Other

Enumeration date
09/01/2006
Last updated
01/05/2017
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