Provider Demographics
NPI:1326029752
Name:PARDUE, MICHELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:PARDUE
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 1:1015 E TRINITY LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-3029
Mailing Address - Country:US
Mailing Address - Phone:615-862-6727
Mailing Address - Fax:615-880-1540
Practice Address - Street 1:1015 E TRINITY LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37216-3029
Practice Address - Country:US
Practice Address - Phone:615-862-6727
Practice Address - Fax:615-880-1540
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice