Provider Demographics
NPI:1053175166
Name:DENTISTRY BY DESIGN
Entity type:Organization
Organization Name:DENTISTRY BY DESIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:931-486-0700
Mailing Address - Street 1:220 TOWN CENTER PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-4408
Mailing Address - Country:US
Mailing Address - Phone:931-486-0700
Mailing Address - Fax:931-486-0709
Practice Address - Street 1:220 TOWN CENTER PKWY STE 130
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-4408
Practice Address - Country:US
Practice Address - Phone:931-486-0700
Practice Address - Fax:931-486-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental