NPI 1417312562

Germantown Dental

Organisation Preferred Provider Organization Nashville, TN

Practice location

Address: 1324 4th Ave N, Nashville, TN 37208-2716
Phone: (615) 742-5578

Authorised official

Name: James Kellum
Title: Dentist
Phone: (615) 604-5584

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 8995 (TN)

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Registry record

NPI: 1417312562
Entity type: Organization
NPI issued: 16 Dec 2015
Record last updated: 16 Dec 2015

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.