Grace Dental Pllc | |
304 Providence Blvd Clarksville TN 37042 | |
(931) 648-4100 | |
(931) 648-4988 |
Full Name | Grace Dental Pllc |
---|---|
Speciality | Dentist - General Practice |
Location | 304 Providence Blvd, Clarksville, Tennessee |
Authorized Official Name and Position | Grace Lee (OWNER) |
Authorized Official Contact | 9316484100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Grace Dental Pllc 304 Providence Blvd Clarksville TN 37042-4326 Ph: (931) 648-4100 | Grace Dental Pllc 304 Providence Blvd Clarksville TN 37042 Ph: (931) 648-4100 |
NPI Number | 1316477144 |
---|---|
Provider Enumeration Date | 06/14/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316477144 | NPI | - | NPPES |
Q037677 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (Tennessee) | Primary |
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