Provider Demographics
NPI:1700596335
Name:TOTAL MOBILE DENTAL, PLLC
Entity Type:Organization
Organization Name:TOTAL MOBILE DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JANEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:337-654-9044
Mailing Address - Street 1:115 CEDAR PLACE BND
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2516
Mailing Address - Country:US
Mailing Address - Phone:629-248-1864
Mailing Address - Fax:
Practice Address - Street 1:7619 HIGHWAY 70 SOUTH
Practice Address - Street 2:210302
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-9998
Practice Address - Country:US
Practice Address - Phone:629-248-1864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty