Provider Demographics
NPI:1548301641
Name:FAMILY DENTISTRY OF SEYMOUR
Entity type:Organization
Organization Name:FAMILY DENTISTRY OF SEYMOUR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUANNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-376-0011
Mailing Address - Street 1:11618 CHAPMAN HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-3910
Mailing Address - Country:US
Mailing Address - Phone:865-579-5010
Mailing Address - Fax:865-579-5047
Practice Address - Street 1:11618 CHAPMAN HWY
Practice Address - Street 2:SUITE B
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-3910
Practice Address - Country:US
Practice Address - Phone:865-579-5010
Practice Address - Fax:865-579-5047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty