Provider Demographics
NPI:1396397147
Name:DUFURRENA, CASEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:DUFURRENA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WENDELWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3746
Mailing Address - Country:US
Mailing Address - Phone:615-904-1585
Mailing Address - Fax:
Practice Address - Street 1:125 WENDELWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3746
Practice Address - Country:US
Practice Address - Phone:615-904-1585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN110271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice