Organization · NPI-2

615 Dental

Dentist · Murfreesboro, TN

NPI number1043685456
StatusActive
Last updated in NPPESDec 10, 2015

Details

NPI
1043685456
Entity type
Organization (NPI-2)
Legal business name
615 Dental
Organization subpart
No
Enumeration date
Dec 10, 2015
Last updated
Dec 10, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist––Yes

Other names

  • Blackman Grove Dental (Doing Business As)

Practice location

4183 Franklin Rd
Suite B5
Murfreesboro, TN 37128-4254

Phone 615-907-4746 · Fax 615-907-4796

Mailing address

4183 Franklin Rd
Suite B5
Murfreesboro, TN 37128-4254

Phone 615-907-4746 · Fax 615-907-4796

Authorized official

Shawn Foster
Practice Administrator
6159074746

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