Provider Demographics
NPI:1942281571
Name:MCKEE, CURRY, STANLEY, PEDIATRIC DENTISTRY PARTNERSHIP
Entity Type:Organization
Organization Name:MCKEE, CURRY, STANLEY, PEDIATRIC DENTISTRY PARTNERSHIP
Other - Org Name:WILD ABOUT SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-890-0885
Mailing Address - Street 1:614 E CLARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2121
Mailing Address - Country:US
Mailing Address - Phone:615-890-0885
Mailing Address - Fax:615-890-8818
Practice Address - Street 1:614 E CLARK BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2121
Practice Address - Country:US
Practice Address - Phone:615-890-0885
Practice Address - Fax:615-890-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1524190Medicaid