| Centerville Dental | |
|
704 Highway 100 Ste 101 Centerville TN 37033-1171 | |
| (931) 729-2664 | |
| (931) 729-2666 |
| Full Name | Centerville Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 704 Highway 100, Centerville, Tennessee |
| Authorized Official Name and Position | Jamie M Lee (OWNER) |
| Authorized Official Contact | 9317292664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerville Dental 704 Highway 100 Ste 101 Centerville TN 37033-1171 Ph: (931) 729-2664 | Centerville Dental 704 Highway 100 Ste 101 Centerville TN 37033-1171 Ph: (931) 729-2664 |
| NPI Number | 1174881965 |
|---|---|
| Provider Enumeration Date | 04/30/2012 |
| Last Update Date | 04/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174881965 | NPI | - | NPPES |
| 5441233 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8074 (Tennessee) | Primary |
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Bobby Morrison Dds & Barry Pendergrass Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1824 Ray Morrison Dr, Centerville, TN 37033 Phone: 931-729-3356 Fax: 931-729-7778 |