Organization
CD TENNESSEE DENTAL, P.C.
Active
Other names
Brentwood Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
TY JUSTICE (DIRECTOR, PAYER RELATIONS)
(513) 609-4076
Entity
Organization
Contact information
Practice address
8112 ISABELLA LN STE 101, BRENTWOOD, TN 37027-9102
(615) 778-0810
(615) 277-0808
Mailing address
9825 KENWOOD RD STE 200, BLUE ASH, OH 45242-6252
(513) 609-4115
(513) 448-0511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
10/18/2018
Last updated
05/03/2023
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