Provider Demographics
NPI:1518194448
Name:MT. JULIET FAMILY DENTISTRY
Entity Type:Organization
Organization Name:MT. JULIET FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:SCALLIONS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-758-2085
Mailing Address - Street 1:66 E HILL DR STE A
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8031
Mailing Address - Country:US
Mailing Address - Phone:615-758-2085
Mailing Address - Fax:615-758-2874
Practice Address - Street 1:66 E HILL DR STE A
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-8031
Practice Address - Country:US
Practice Address - Phone:615-758-2085
Practice Address - Fax:615-758-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty