Organization
VIBE DENTAL OF FAIRVIEW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN MCCONNELL (SUPPORT OFFICER)
(931) 205-6838
Entity
Organization
Contact information
Practice address
1696 FAIRVIEW BLVD STE 104, FAIRVIEW, TN 37062-5144
(615) 799-9234
Mailing address
317 S 2ND ST, PULASKI, TN 38478-3842
(931) 205-6838
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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