Organization
BIVENS DENTAL GROUP PC
Active
Parent organization
BIVENS DENTAL GROUP PC
Other names
Hickman Dental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BIVENS DENTAL GROUP PC
Authorized official
DARRYL A BIVENS DDS (DENTIST)
(931) 670-5961
Entity
Organization
Contact information
Practice address
5103 HIGHWAY 100, LYLES, TN 37098-1879
(931) 670-5961
Mailing address
5103 HIGHWAY 100, LYLES, TN 37098-1879
(931) 670-5961
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6858
TN
Other
Enumeration date
11/04/2008
Last updated
11/05/2008
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