Provider Demographics
NPI:1982034435
Name:KELLEY N. RICE, DMD PLLC
Entity Type:Organization
Organization Name:KELLEY N. RICE, DMD PLLC
Other - Org Name:COOL SPRINGS LASER DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLYE
Authorized Official - Middle Name:N
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-373-4488
Mailing Address - Street 1:1800 MALLORY LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2818
Mailing Address - Country:US
Mailing Address - Phone:615-373-4488
Mailing Address - Fax:615-373-0054
Practice Address - Street 1:1800 MALLORY LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2818
Practice Address - Country:US
Practice Address - Phone:615-373-4488
Practice Address - Fax:615-373-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS47131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty