Organization
MD ABERNATHY JR DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOULTON D ABERNATHY JR. DDS (OWNER)
(731) 847-6453
Entity
Organization
Contact information
Practice address
213 W MAIN ST, PARSONS, TN 38363-2018
(731) 847-6453
(731) 847-6399
Mailing address
213 W MAIN ST, PARSONS, TN 38363-2018
(731) 847-6453
(731) 847-6399
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS3005
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1502954
—
TN
Enumeration date
01/12/2016
Last updated
01/12/2016
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