Provider Demographics
NPI:1255317459
Name:NAPIER-SUDEKUM DENTAL CLINIC
Entity Type:Organization
Organization Name:NAPIER-SUDEKUM DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-256-7543
Mailing Address - Street 1:451 MURFREESBORO RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37721-2842
Mailing Address - Country:US
Mailing Address - Phone:615-256-7543
Mailing Address - Fax:615-256-8895
Practice Address - Street 1:451 MURFREESBORO RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37721-2842
Practice Address - Country:US
Practice Address - Phone:615-256-7543
Practice Address - Fax:615-256-8895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3225887Medicaid