Tom Spain Bigham III, DDS

Individual provider Active NPI General Practice Dentistry · Fayetteville, TN

NPI 1144388992 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1144388992
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS2404 (TN)
Practice address
608 West College Street
Fayetteville, TN 37334
Phone
(931) 433-6169
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS2404TNMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS2404 TN Yes

Addresses

Primary practice location

608 West College Street
Fayetteville, TN 37334

Mailing address

608 West College Street
Fayetteville, TN 37334
Phone (931) 433-6169

Other providers in Fayetteville, TN

All providers in Fayetteville, TN · General Practice Dentistry in Tennessee

Sources for this page

Verify at the official NPI Registry.