Provider Demographics
NPI:1245416429
Name:HAROLD C. PEEPLES, DDS, PC
Entity Type:Organization
Organization Name:HAROLD C. PEEPLES, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:PEEPLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-859-3344
Mailing Address - Street 1:85 CUDE LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2292
Mailing Address - Country:US
Mailing Address - Phone:615-859-3344
Mailing Address - Fax:615-859-3370
Practice Address - Street 1:85 CUDE LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2292
Practice Address - Country:US
Practice Address - Phone:615-859-3344
Practice Address - Fax:615-859-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000029011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3223248Medicare PIN