Provider Demographics
NPI:1912174624
Name:EDWARD C. PERDUE, D.D.S., L.L.C.
Entity Type:Organization
Organization Name:EDWARD C. PERDUE, D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:RDA
Authorized Official - Phone:615-662-2191
Mailing Address - Street 1:8120 SAWYER BROWN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-1410
Mailing Address - Country:US
Mailing Address - Phone:615-662-2191
Mailing Address - Fax:615-662-2129
Practice Address - Street 1:8120 SAWYER BROWN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-1410
Practice Address - Country:US
Practice Address - Phone:615-662-2191
Practice Address - Fax:615-662-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty