Organization
HERMITAGE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES A. BURDESHAW DDS (OWNER)
(615) 889-1654
Entity
Organization
Contact information
Practice address
107 BONNABROOK DR STE 1, HERMITAGE, TN 37076-1910
(615) 889-1654
(615) 316-9197
Mailing address
107 BONNABROOK DR STE 1, HERMITAGE, TN 37076-1910
(615) 889-1654
(615) 316-9197
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1764
TN
Other
Enumeration date
03/07/2007
Last updated
08/22/2020
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