Provider Demographics
NPI:1871753400
Name:POSS, STEPHEN D (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:POSS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1177 OLD HICKORY BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4244
Mailing Address - Country:US
Mailing Address - Phone:615-850-8445
Mailing Address - Fax:615-535-9992
Practice Address - Street 1:1177 OLD HICKORY BLVD STE 203
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4244
Practice Address - Country:US
Practice Address - Phone:158-508-4456
Practice Address - Fax:615-535-9992
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0041321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
6352440001Medicare NSC