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Organization

ABSOLUTE PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH S DOCTORA DDS (OWNER)
(931) 455-8255
Entity
Organization

Contact information

Practice address
1956 N JACKSON ST, TULLAHOMA, TN 37388-2204
(931) 455-8255
(931) 563-5566
Mailing address
1956 N JACKSON ST, TULLAHOMA, TN 37388-2204
(931) 455-8255
(931) 563-5566

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1223S0112X
Oral and Maxillofacial Surgery (Dentist)

Other

Enumeration date
10/29/2013
Last updated
10/29/2013
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