Provider Demographics
NPI:1902194947
Name:BRENTWOOD DENTAL ARTS PLLC
Entity Type:Organization
Organization Name:BRENTWOOD DENTAL ARTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:HOLLIDAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-331-0402
Mailing Address - Street 1:5505 EDMONDSON PIKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5872
Mailing Address - Country:US
Mailing Address - Phone:615-331-0402
Mailing Address - Fax:615-832-5410
Practice Address - Street 1:5505 EDMONDSON PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5872
Practice Address - Country:US
Practice Address - Phone:615-331-0402
Practice Address - Fax:615-832-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23641223G0001X
TN87111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty