Provider Demographics
NPI:1013409887
Name:ROBERTSON COUNTY PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:ROBERTSON COUNTY PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:
Authorized Official - Last Name:BATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-245-3333
Mailing Address - Street 1:3130 TOM AUSTIN HWY STE B
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-4579
Mailing Address - Country:US
Mailing Address - Phone:615-382-9005
Mailing Address - Fax:
Practice Address - Street 1:3130 TOM AUSTIN HWY STE B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172
Practice Address - Country:US
Practice Address - Phone:931-245-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty