Organization
DENTAL SPA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACIE BATTLE D.M.D. (DENTIST)
(615) 459-2579
Entity
Organization
Contact information
Practice address
125 ENON SPRINGS RD E, SMYRNA, TN 37167-3032
(615) 459-2579
Mailing address
PO BOX 2623, BRENTWOOD, TN 37024-2623
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8012
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12454814
—
TN
Enumeration date
10/13/2014
Last updated
10/13/2014
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