Maple Leaf Implant And General Dentistry, Pllc

LBN: Maple Leaf Implant And General Dentistry, Pllc
Maple Leaf Implant And General Dentistry, Pllc is an health care organization with primary practice located at 220 N Washington Ave , Cookeville TN 38501-2642. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Maple Leaf Implant And General Dentistry, Pllc can be contacted via phone (931) 526-2613, or through Bryant, Jerald A via phone (931) 526-2613.

Contact Information

Primary practice address
220 N Washington Ave Cookeville TN 38501-2642
Phone: (931) 526-2613
Fax: (931) 646-0901
Website:
Map and Directions
Authorized official contact:
Name: Bryant, Jerald A Doctor of Dental Surgery (DDS)
Phone: (931) 526-2613

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 7879 Tennessee

Profile Details

NPI number 1679879415
LBN Legal business name Maple Leaf Implant And General Dentistry, Pllc
DBA Doing business as
Authorized official Bryant, Jerald A Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 26th, 2011
Last updated Feb 15th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679879415 NPPES
Tennessee MEDICAID Q009025

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