Provider Demographics
NPI:1427407733
Name:CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS OF MURFREESBORO, PLLC
Entity Type:Organization
Organization Name:CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS OF MURFREESBORO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-220-6161
Mailing Address - Street 1:277 VETERANS PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-6930
Mailing Address - Country:US
Mailing Address - Phone:615-220-6161
Mailing Address - Fax:
Practice Address - Street 1:739 PRESIDENT PL
Practice Address - Street 2:STE 200
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6844
Practice Address - Country:US
Practice Address - Phone:615-220-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty