Provider Demographics
NPI:1902640725
Name:SMITH, RYLEE BROOKE (DDS)
Entity type:Individual
Prefix:
First Name:RYLEE
Middle Name:BROOKE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305B MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-2047
Mailing Address - Country:US
Mailing Address - Phone:901-356-1898
Mailing Address - Fax:
Practice Address - Street 1:117 INDIAN LAKE BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6204
Practice Address - Country:US
Practice Address - Phone:615-813-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN125201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice