Provider Demographics
NPI:1730324948
Name:LA PAZ DENTAL CLINIC
Entity type:Organization
Organization Name:LA PAZ DENTAL CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SABIN
Authorized Official - Middle Name:KANE
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-220-8585
Mailing Address - Street 1:4057 NOLENSVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-333-1360
Mailing Address - Fax:615-333-1318
Practice Address - Street 1:4057 NOLENSVILLE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4547
Practice Address - Country:US
Practice Address - Phone:615-333-1360
Practice Address - Fax:615-333-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN79071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty