Cookeville Regional Dental Associates
Dentist, General Practice in Cookeville, TN. Organization (NPI-2).
NPI number1972597300
StatusActive
Last updated in NPPESJan 10, 2008
Details
- NPI
- 1972597300
- Entity type
- Organization (NPI-2)
- Legal business name
- Cookeville Regional Dental Associates
- Organization subpart
- No
- Enumeration date
- Aug 31, 2005
- Last updated
- Jan 10, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – |
Practice location
327 N Cedar AveCookeville, TN 38501-2420
Phone 931-528-5105 · Fax 931-528-5118
Mailing address
Po Box 357Cookeville, TN 38503-0357
Phone 931-528-5105 · Fax 931-528-5118
Authorized official
Regina Ann Johnson
Office Manager
9315285105
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