Provider Demographics
NPI:1417645714
Name:ROCK SPRINGS PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:ROCK SPRINGS PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QUANTEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:256-653-8060
Mailing Address - Street 1:1515 DEMONBREUN ST APT 1616
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-4594
Mailing Address - Country:US
Mailing Address - Phone:256-653-8060
Mailing Address - Fax:
Practice Address - Street 1:739 PRESIDENT PL STE 200
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6846
Practice Address - Country:US
Practice Address - Phone:615-439-2420
Practice Address - Fax:615-806-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental