Organization
BLUEGRASS ENDODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANTONIA MORAN (PRACTICE ADMINISTRATOR)
(615) 824-7546
Entity
Organization
Contact information
Practice address
100 BLUEGRASS COMMONS BLVD, STE. 2180, HENDERSONVILLE, TN 37075-2732
(615) 824-7546
(615) 824-7547
Mailing address
100 BLUEGRASS COMMONS BLVD, STE. 2180, HENDERSONVILLE, TN 37075-2732
(615) 824-7546
(615) 824-7547
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
8017
TN
1223E0200X
Endodontics
9429
TN
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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