Organization
ACACIA DENTAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA WILBURN SOUTHWELL DDS (DENTIST)
(615) 822-2214
Entity
Organization
Contact information
Practice address
102 WESSINGTON PL, SUITE B, HENDERSONVILLE, TN 37075-3085
(615) 822-2214
(615) 822-6519
Mailing address
102 WESSINGTON PL, SUITE B, HENDERSONVILLE, TN 37075-3085
(615) 822-2214
(615) 822-6519
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8834
TN
Other
Enumeration date
12/29/2016
Last updated
02/06/2017
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