Organization
LEBANON DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STARLENA GANNON (MANAGER)
(615) 440-8800
Entity
Organization
Contact information
Practice address
102 HARTMAN DR STE H, LEBANON, TN 37087-1502
(615) 449-8800
(615) 453-6100
Mailing address
102 HARTMAN DR STE H, LEBANON, TN 37087-1502
(615) 449-8800
(615) 453-6100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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