Provider Demographics
NPI:1407523939
Name:BECHTEL, ODREY
Entity Type:Individual
Prefix:DR
First Name:ODREY
Middle Name:
Last Name:BECHTEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-1926
Mailing Address - Country:US
Mailing Address - Phone:773-438-3960
Mailing Address - Fax:763-438-3960
Practice Address - Street 1:127 CLUB PKWY
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-1926
Practice Address - Country:US
Practice Address - Phone:763-438-3960
Practice Address - Fax:763-438-3960
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11626122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist