Provider Demographics
NPI:1790871432
Name:ENDODONTIC ASSOCIATES
Entity Type:Organization
Organization Name:ENDODONTIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-383-4455
Mailing Address - Street 1:8112 ISABELLA LN STE 105
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-9102
Mailing Address - Country:US
Mailing Address - Phone:615-371-9559
Mailing Address - Fax:615-371-9478
Practice Address - Street 1:4027 HILLSBORO PIKE
Practice Address - Street 2:#805
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2744
Practice Address - Country:US
Practice Address - Phone:615-383-4455
Practice Address - Fax:615-383-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty