Organization
MID-CUMBERLAND ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP WAYNE HEAD DDSCAGS (DENTIST)
(931) 388-5627
Entity
Organization
Contact information
Practice address
1324 TROTWOOD AVE, SUITE #2, COLUMBIA, TN 38401-4750
(931) 388-5627
(931) 381-6797
Mailing address
1324 TROTWOOD AVE, SUITE #2, COLUMBIA, TN 38401-4750
(931) 388-5627
(931) 381-6797
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3913-170
TN
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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