Provider Demographics
NPI:1467523233
Name:ROMAN, DENNIS K (DMD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:K
Last Name:ROMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1744
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-1744
Mailing Address - Country:US
Mailing Address - Phone:615-377-9707
Mailing Address - Fax:615-377-9709
Practice Address - Street 1:785 OLD HICKORY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4512
Practice Address - Country:US
Practice Address - Phone:615-377-9707
Practice Address - Fax:615-377-9709
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-51801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice