Provider Demographics
NPI:1396882486
Name:UNLAND, THEODORE FRANCIS IV (DMD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:FRANCIS
Last Name:UNLAND
Suffix:IV
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4757 ANDREW JACKSON PKWY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1301
Mailing Address - Country:US
Mailing Address - Phone:615-885-0181
Mailing Address - Fax:
Practice Address - Street 1:4757 ANDREW JACKSON PKWY
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1301
Practice Address - Country:US
Practice Address - Phone:615-885-0181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8235122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist