Provider Demographics
NPI:1699150235
Name:JUSTIN R POFF DDS, PLLC
Entity type:Organization
Organization Name:JUSTIN R POFF DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:RHETT
Authorized Official - Last Name:POFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-662-2400
Mailing Address - Street 1:7041 HIGHWAY 70 S
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-5238
Mailing Address - Country:US
Mailing Address - Phone:615-662-2400
Mailing Address - Fax:615-662-2423
Practice Address - Street 1:7041 HIGHWAY 70 S
Practice Address - Street 2:SUITE 7
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-5238
Practice Address - Country:US
Practice Address - Phone:615-662-2400
Practice Address - Fax:615-662-2423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9350261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental