Provider Demographics
NPI:1487795068
Name:BARTLETT FAMILY DENTISTRY
Entity type:Organization
Organization Name:BARTLETT FAMILY DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MGR.
Authorized Official - Prefix:MR
Authorized Official - First Name:GEROGE
Authorized Official - Middle Name:GUILFORD
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:III
Authorized Official - Credentials:MHA
Authorized Official - Phone:901-371-0609
Mailing Address - Street 1:7519 US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-8929
Mailing Address - Country:US
Mailing Address - Phone:901-371-0609
Mailing Address - Fax:901-371-0284
Practice Address - Street 1:7519 US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-8929
Practice Address - Country:US
Practice Address - Phone:901-371-0609
Practice Address - Fax:901-371-0284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty