Provider Demographics
NPI:1306488622
Name:CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS OF COOL SPRINGS, PLLC
Entity type:Organization
Organization Name:CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS OF COOL SPRINGS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GOINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:615-478-7166
Mailing Address - Street 1:1540 ROCK SPRINGS ROAD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167
Mailing Address - Country:US
Mailing Address - Phone:615-390-3718
Mailing Address - Fax:
Practice Address - Street 1:1201 LIBERTY PIKE
Practice Address - Street 2:SUITE 202-B
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-930-3718
Practice Address - Fax:615-625-3473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty