Provider Demographics
NPI:1689980831
Name:FRANKLIN ENDODONTICS, PC
Entity Type:Organization
Organization Name:FRANKLIN ENDODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALETHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:615-957-1823
Mailing Address - Street 1:1025 WESTHAVEN BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-4894
Mailing Address - Country:US
Mailing Address - Phone:615-595-1550
Mailing Address - Fax:615-595-1548
Practice Address - Street 1:1025 WESTHAVEN BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-4894
Practice Address - Country:US
Practice Address - Phone:615-595-1550
Practice Address - Fax:615-595-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNFB0988571OtherDEA NUMBER