Provider Demographics
NPI:1316071129
Name:SAIN, DAVID RUSSELL (DDS, MS, PC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RUSSELL
Last Name:SAIN
Suffix:
Gender:M
Credentials:DDS, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1849 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1522
Mailing Address - Country:US
Mailing Address - Phone:615-890-7246
Mailing Address - Fax:615-890-6885
Practice Address - Street 1:1849 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1522
Practice Address - Country:US
Practice Address - Phone:615-890-7246
Practice Address - Fax:615-890-6885
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-35741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics