Provider Demographics
NPI:1689454829
Name:RICHLAND CREEK FAMILY DENTISTRY PLLC
Entity Type:Organization
Organization Name:RICHLAND CREEK FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ELVIN
Authorized Official - Last Name:MCNUTT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-310-8897
Mailing Address - Street 1:406 MORROW RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3011
Mailing Address - Country:US
Mailing Address - Phone:615-383-1444
Mailing Address - Fax:615-383-4085
Practice Address - Street 1:406 MORROW RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3011
Practice Address - Country:US
Practice Address - Phone:615-383-1444
Practice Address - Fax:615-383-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty