Provider Demographics
NPI:1659580561
Name:HEATHER RIDGWAY DDS, MS, PC
Entity Type:Organization
Organization Name:HEATHER RIDGWAY DDS, MS, PC
Other - Org Name:COOL SPRINGS PERIODONTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:KECK
Authorized Official - Last Name:RIDGWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:615-887-8948
Mailing Address - Street 1:510 BRENNAN LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6235
Mailing Address - Country:US
Mailing Address - Phone:615-887-8948
Mailing Address - Fax:
Practice Address - Street 1:510 BRENNAN LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6235
Practice Address - Country:US
Practice Address - Phone:615-887-8948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN85751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty