Provider Demographics
NPI:1053459289
Name:KEMP, PHILLIP A (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:A
Last Name:KEMP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 MARYLAND WAY
Mailing Address - Street 2:SUITE 190
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7508
Mailing Address - Country:US
Mailing Address - Phone:615-373-2030
Mailing Address - Fax:615-373-7059
Practice Address - Street 1:5110 MARYLAND WAY
Practice Address - Street 2:SUITE 190
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7508
Practice Address - Country:US
Practice Address - Phone:615-373-2030
Practice Address - Fax:615-373-7059
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0050631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice