Provider Demographics
NPI:1407152135
Name:APEX ENDODONTICS OF TN PLLC
Entity Type:Organization
Organization Name:APEX ENDODONTICS OF TN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-353-5678
Mailing Address - Street 1:1050 GLENBROOK WAY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1241
Mailing Address - Country:US
Mailing Address - Phone:615-824-5526
Mailing Address - Fax:615-824-7576
Practice Address - Street 1:1050 GLENBROOK WAY
Practice Address - Street 2:SUITE 350
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1241
Practice Address - Country:US
Practice Address - Phone:615-824-5526
Practice Address - Fax:615-824-7576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN83691223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty