Provider Demographics
NPI:1861827032
Name:MICHAEL A. ATCHLEY, DDS P.C.
Entity Type:Organization
Organization Name:MICHAEL A. ATCHLEY, DDS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATCHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-847-1234
Mailing Address - Street 1:601 BRANDYWINE CT
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-2122
Mailing Address - Country:US
Mailing Address - Phone:615-847-1234
Mailing Address - Fax:615-847-1606
Practice Address - Street 1:601 BRANDYWINE CT
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-2122
Practice Address - Country:US
Practice Address - Phone:615-847-1234
Practice Address - Fax:615-847-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4127OtherTN STATE DENTAL LICENSE