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Organization

TREASURE ISLAND PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS LISA K PAUL (PRACTICE MANAGER)
(931) 698-0200
Entity
Organization

Contact information

Practice address
1900 MEDICAL CENTER PARKWAY, 110, MURFREESBORO, TN 37129
(931) 444-5437
Mailing address
4119 SCOTT HOLLOW RD, CULLEOKA, TN 38451-3108
(931) 444-5437

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q001715
TN
Enumeration date
02/12/2020
Last updated
02/12/2020
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