Provider Demographics
NPI:1790237477
Name:WESTPHAL ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:WESTPHAL ORTHODONTICS, PLLC
Other - Org Name:SMILES FROM THE HART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HART WESTPHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MDS
Authorized Official - Phone:615-452-2868
Mailing Address - Street 1:355 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3690
Mailing Address - Country:US
Mailing Address - Phone:615-452-2868
Mailing Address - Fax:
Practice Address - Street 1:355 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3690
Practice Address - Country:US
Practice Address - Phone:615-452-2868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9017261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental