Organization
HERMITAGE PEDIATRIC DENTISTRY, PLLC
Active
Parent organization
HERMITAGE PEDIATRIC DENTSITRY
Other names
Zoo Crew Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERMITAGE PEDIATRIC DENTSITRY
Authorized official
MS. JENNI SNOW (CREDENTIALING COORDINATOR)
(404) 410-1340
Entity
Organization
Contact information
Practice address
1100 NEAL ST STE B, COOKEVILLE, TN 38501-0900
(931) 349-7807
(615) 316-9197
Mailing address
1100 NEAL ST STE B, COOKEVILLE, TN 38501-0900
(931) 349-7807
(615) 316-9197
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/11/2016
Last updated
12/05/2016
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