Provider Demographics
NPI:1508362534
Name:DAILY DENTAL DDS PC
Entity Type:Organization
Organization Name:DAILY DENTAL DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SHAY
Authorized Official - Last Name:TILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-392-5600
Mailing Address - Street 1:2090 WALL ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-4208
Mailing Address - Country:US
Mailing Address - Phone:615-392-5810
Mailing Address - Fax:931-300-2345
Practice Address - Street 1:2090 WALL ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174
Practice Address - Country:US
Practice Address - Phone:615-392-5600
Practice Address - Fax:615-392-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty