Lewisburg Smile Studio
Clinic/Center, Dental in Lewisburg, TN. Organization (NPI-2).
NPI number1003669912
StatusActive
Last updated in NPPESApr 10, 2024
Details
- NPI
- 1003669912
- Entity type
- Organization (NPI-2)
- Legal business name
- Lewisburg Smile Studio
- Organization subpart
- No
- Enumeration date
- Apr 10, 2024
- Certification date
- Apr 9, 2024
- Last updated
- Apr 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
302 W Church StLewisburg, TN 37091-2730
Phone 931-359-6154
Mailing address
1508 Highway 64 WShelbyville, TN 37160-6315
Phone 615-418-9021
Authorized official
Raymond C Branch
Owner
6154189021
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