Organization
SOH OF TENNESSEE PLLC
Active
Parent organization
SOHDENTAL LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOHDENTAL LLC
Authorized official
RAY WEBER (REGIONAL SUPPORT SPECIALIST)
(314) 753-8154
Entity
Organization
Contact information
Practice address
1600 WESTGATE CIR, BRENTWOOD, TN 37027-8059
(615) 481-4555
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
(636) 362-4986
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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