NPI 1275707853

Prosperity Cosmetic & General Dentistry

Organisation Exclusive Provider Organization Nashville, TN

Practice location

Address: 908 34th Ave N Suite a, Nashville, TN 37209-2502
Phone: (615) 720-3765
Fax: (615) 327-0546

Authorised official

Name: Brenda Lesia Moore
Title: Dentist
Phone: (615) 720-3765

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 8455 (TN)

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Registry record

NPI: 1275707853
Entity type: Organization
NPI issued: 15 Apr 2008
Record last updated: 15 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.