Provider Demographics
NPI:1417073255
Name:COLEMAN, HELEN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:L
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HELEN
Other - Middle Name:L
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:113 5TH AVENUE WEST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-2428
Mailing Address - Country:US
Mailing Address - Phone:615-384-2858
Mailing Address - Fax:615-384-2884
Practice Address - Street 1:113 5TH AVE W
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2428
Practice Address - Country:US
Practice Address - Phone:615-384-2858
Practice Address - Fax:615-384-2884
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7203TN1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2204227Medicaid
TN2204227Medicaid