Organization
TRACE ORAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LUCAS (PRESIDENT)
(615) 377-7777
Entity
Organization
Contact information
Practice address
7146 NOLENSVILLE RD, NOLENSVILLE, TN 37135-9585
(615) 776-3442
Mailing address
7004 MOORES LN, BRENTWOOD, TN 37027-2905
(615) 377-7777
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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