Clarksville Oral And Facial Surgery, Pllc | |
1718 Memorial Dr Clarksville TN 37043-4542 | |
(931) 552-4935 | |
(931) 552-0959 |
Full Name | Clarksville Oral And Facial Surgery, Pllc |
---|---|
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1718 Memorial Dr, Clarksville, Tennessee |
Authorized Official Name and Position | Jason Scott Lilly (OWNER) |
Authorized Official Contact | 9315527575 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Clarksville Oral And Facial Surgery, Pllc 1718 Memorial Dr Clarksville TN 37043-4542 Ph: (931) 552-4935 | Clarksville Oral And Facial Surgery, Pllc 1718 Memorial Dr Clarksville TN 37043-4542 Ph: (931) 552-4935 |
NPI Number | 1073748042 |
---|---|
Provider Enumeration Date | 05/20/2009 |
Last Update Date | 06/15/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073748042 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4003 (Tennessee) | Primary |
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