Organization
LEBANON DENTAL GROUP
Active
Other names
Champion Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL CHAMPION (PRESIDENT)
(615) 554-7401
Entity
Organization
Contact information
Practice address
322 N MAPLE ST, LEBANON, TN 37087-2706
(615) 554-7401
(615) 807-3303
Mailing address
322 N MAPLE ST, LEBANON, TN 37087-2706
(615) 554-7401
(615) 807-3303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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