| Organization Name: | CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS |
| NPI Number: | 1770837858 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARITY CLEVELAND (OFFICE ADMINISTRATOR) |
| Mailing Address: | 520 Highway 76 Suite 8 White House |
| State: | TN US |
| Postal Code: | 371888212 |
| Phone Number: | 6156727221 |
| Fax Number: | 6156727211 |
| NPI Enumeration Date: | 10/29/2012 |
| NPI Last Update Date: | 10/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 8564 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |