Provider Demographics
NPI:1447625157
Name:PLEASANT VIEW DENTAL SPA PLLC.
Entity type:Organization
Organization Name:PLEASANT VIEW DENTAL SPA PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-509-9858
Mailing Address - Street 1:6312 HIGHWAY 41A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-8221
Mailing Address - Country:US
Mailing Address - Phone:615-746-3700
Mailing Address - Fax:615-746-3745
Practice Address - Street 1:6312 HIGHWAY 41A
Practice Address - Street 2:SUITE 100
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-8221
Practice Address - Country:US
Practice Address - Phone:615-746-3700
Practice Address - Fax:615-746-3745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty