Provider Demographics
NPI:1083914378
Name:THE ART OF DENTISTRY
Entity Type:Organization
Organization Name:THE ART OF DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-381-6880
Mailing Address - Street 1:1605 NASHVILLE HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-2071
Mailing Address - Country:US
Mailing Address - Phone:931-381-6880
Mailing Address - Fax:931-381-3093
Practice Address - Street 1:1605 NASHVILLE HWY
Practice Address - Street 2:STE 100
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2071
Practice Address - Country:US
Practice Address - Phone:931-381-6880
Practice Address - Fax:931-381-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7881292200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes292200000XLaboratoriesDental Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3208728Medicaid
TN1255414140OtherTYPE 1 NPI