Organization
SOH OF TENNEESSEE SPECIALTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLY SUNSHINE (CREDENTIALING)
(636) 362-4986
Entity
Organization
Contact information
Practice address
330 MAYFIELD DR STE A15, FRANKLIN, TN 37067-7210
(636) 362-4986
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
(636) 362-4986
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/24/2023
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