Provider Demographics
NPI:1700418068
Name:JOLLY AND MORTON ADVANCED DENTISTRY
Entity Type:Organization
Organization Name:JOLLY AND MORTON ADVANCED DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SKYLOR
Authorized Official - Middle Name:RHEA
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-970-2300
Mailing Address - Street 1:785 OLD HICKORY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4512
Mailing Address - Country:US
Mailing Address - Phone:615-373-5930
Mailing Address - Fax:
Practice Address - Street 1:785 OLD HICKORY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4512
Practice Address - Country:US
Practice Address - Phone:615-373-5930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty