Provider Demographics
NPI:1083275523
Name:VIE, ANGELA MAY (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MAY
Last Name:VIE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:MAY
Other - Last Name:VIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:6996 SONYA DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5228
Mailing Address - Country:US
Mailing Address - Phone:315-430-4512
Mailing Address - Fax:
Practice Address - Street 1:468 CROCKETT TRACE DR UNIT 1
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2162
Practice Address - Country:US
Practice Address - Phone:423-581-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11125122300000X
TNUNISSUED122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist