Provider Demographics
NPI:1740451426
Name:COOL WATER ORTHODONTICS
Entity type:Organization
Organization Name:COOL WATER ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWAF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,CAGS
Authorized Official - Phone:615-778-1800
Mailing Address - Street 1:1550 W MCEWEN DR STE 60
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1770
Mailing Address - Country:US
Mailing Address - Phone:156-778-1800
Mailing Address - Fax:615-778-1880
Practice Address - Street 1:1550 W MCEWEN DR STE 60
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1770
Practice Address - Country:US
Practice Address - Phone:615-778-1800
Practice Address - Fax:615-778-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8480122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5440847Medicaid