Provider Demographics
NPI:1265784631
Name:COOL SPRINGS FAMILY DENTISTRY
Entity type:Organization
Organization Name:COOL SPRINGS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWENR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-942-7811
Mailing Address - Street 1:8113 MOORES LN
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8037
Mailing Address - Country:US
Mailing Address - Phone:615-942-7811
Mailing Address - Fax:615-942-7609
Practice Address - Street 1:8113 MOORES LN
Practice Address - Street 2:SUITE 2100
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8037
Practice Address - Country:US
Practice Address - Phone:615-942-7811
Practice Address - Fax:615-942-7609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN91551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty