Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | D.S. 1179 | TN |
NPI | 1275522674 |
---|---|
Provider Name | Dr. James O. Cantrell |
First Address | Brentwood, TN 37027-4909 |
Second Address | Nashville, TN 37210-2842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 23/06/2014 |