Provider Demographics
NPI:1174386627
Name:DISCOVERY EXPEDITIONS
Entity type:Organization
Organization Name:DISCOVERY EXPEDITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DONELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-481-9918
Mailing Address - Street 1:1300 N ELLINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-2218
Mailing Address - Country:US
Mailing Address - Phone:931-359-2825
Mailing Address - Fax:
Practice Address - Street 1:1300 N ELLINGTON PKWY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-2218
Practice Address - Country:US
Practice Address - Phone:931-359-2825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty