Provider Demographics
NPI:1154407906
Name:CORNERSTONE ORAL HEALTH CARE PC
Entity type:Organization
Organization Name:CORNERSTONE ORAL HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT OF CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:B ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-333-3382
Mailing Address - Street 1:404 WELSHWOOD DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-333-3382
Mailing Address - Fax:615-832-1293
Practice Address - Street 1:404 WELSHWOOD DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-333-3382
Practice Address - Fax:615-832-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-44401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty