Provider Demographics
NPI:1326691551
Name:PHILLIP A. KEMP D.D.S. PLLC
Entity Type:Organization
Organization Name:PHILLIP A. KEMP D.D.S. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-2030
Mailing Address - Street 1:5110 MARYLAND WAY STE 190
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7508
Mailing Address - Country:US
Mailing Address - Phone:615-373-2030
Mailing Address - Fax:615-373-7059
Practice Address - Street 1:5110 MARYLAND WAY STE 190
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7508
Practice Address - Country:US
Practice Address - Phone:615-373-2030
Practice Address - Fax:615-373-7059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental