Provider Demographics
NPI:1003107673
Name:MEHARRY MEDICAL COLLEGE, SCHOOL OF DENTISTRY
Entity Type:Organization
Organization Name:MEHARRY MEDICAL COLLEGE, SCHOOL OF DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MA,MBA
Authorized Official - Phone:615-327-6360
Mailing Address - Street 1:1007 DB TODD BLVD
Mailing Address - Street 2:MEHARRY MEDICAL COLLEGE, SCHOOL OF DENTISTRY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208
Mailing Address - Country:US
Mailing Address - Phone:615-327-6360
Mailing Address - Fax:
Practice Address - Street 1:1007 DB TODD BLVD
Practice Address - Street 2:MEHARRY MEDICAL COLLEGE, SCHOOL OF DENTISTRY 1007DB TOD
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6360
Practice Address - Fax:615-327-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7823261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental