Provider Demographics
NPI:1083901573
Name:FRANKLIN PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:FRANKLIN PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:YEZERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-591-8880
Mailing Address - Street 1:509 NEW HIGHWAY 96 W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2556
Mailing Address - Country:US
Mailing Address - Phone:615-591-8880
Mailing Address - Fax:
Practice Address - Street 1:509 NEW HIGHWAY 96 W
Practice Address - Street 2:SUITE 100
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2556
Practice Address - Country:US
Practice Address - Phone:615-591-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty