Individual
SHANIKA PAULLEAN MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7057 HIGHWAY 70 S, NASHVILLE, TN 37221-2207
(615) 673-7627
Mailing address
7057 HIGHWAY 70 S, NASHVILLE, TN 37221-2207
(615) 673-7627
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000011191
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
02/23/2019
Last updated
06/17/2020
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