Organization
HERITAGE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN PAUL BRADSHAW DDS (OWNER)
(865) 986-5310
Entity
Organization
Contact information
Practice address
11121 KINGSTON PIKE STE C, FARRAGUT, TN 37934-2890
(865) 986-5310
Mailing address
11121 KINGSTON PIKE STE C, FARRAGUT, TN 37934-2890
(865) 986-5310
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS8701
TN
Other
Enumeration date
02/13/2015
Last updated
09/08/2023
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