Provider Demographics
NPI:1578844551
Name:EAST HILLS DENTAL CENTER PLLC
Entity Type:Organization
Organization Name:EAST HILLS DENTAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-446-4644
Mailing Address - Street 1:102 HWY 70 EAST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055
Mailing Address - Country:US
Mailing Address - Phone:615-446-4644
Mailing Address - Fax:615-446-4660
Practice Address - Street 1:102 HWY 70 EAST
Practice Address - Street 2:SUITE 3
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055
Practice Address - Country:US
Practice Address - Phone:615-446-4644
Practice Address - Fax:615-446-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS30961223G0001X
TNDS78711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty