Individual
BARRY S PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1824 RAY MORRISON DR, CENTERVILLE, TN 37033-3000
(931) 729-3356
Mailing address
1824 RAY MORRISON DR, CENTERVILLE, TN 37033-3000
(931) 729-3356
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS6908
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS6908
DENTAL LIC
TN
Enumeration date
10/23/2006
Last updated
07/08/2007
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