Provider Demographics
NPI:1851648620
Name:COTTRILL, ADAM WINSTON (DMD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:WINSTON
Last Name:COTTRILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 BRANSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3102
Mailing Address - Country:US
Mailing Address - Phone:615-378-5019
Mailing Address - Fax:
Practice Address - Street 1:2828 BRANSFORD AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3102
Practice Address - Country:US
Practice Address - Phone:615-378-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2018-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31745122300000X
TN9486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist