Southeastern Dental Pllc

NPI #1386209849 in Madison, Tennessee

Provider Information

NPI Number: 1386209849
Entity Type: Organization
Organization Name: Southeastern Dental Pllc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: May 9, 2019
Last Updated: May 9, 2019

Practice Location

Address: 117 GALLATIN PIKE N
City: Madison
State: Tennessee
ZIP Code: 37115-3701
Phone: (615) 868-6177

Authorized Official

Name: VICKIE J METCALF
Title: PRACTICE ADMINISTRATOR
Phone: (615) 568-3258

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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