| Alpha Dental, Pllc | |
|
2485 Fort Campbell Blvd Ste 101 Clarksville TN 37042 | |
| (931) 431-0200 | |
| (931) 431-3022 |
| Full Name | Alpha Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2485 Fort Campbell Blvd, Clarksville, Tennessee |
| Authorized Official Name and Position | Matthew Palomaki (OWNER) |
| Authorized Official Contact | 9314310200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Dental, Pllc 2485 Fort Campbell Blvd Ste 101 Clarksville TN 37042 Ph: (931) 431-0200 | Alpha Dental, Pllc 2485 Fort Campbell Blvd Ste 101 Clarksville TN 37042 Ph: (931) 431-0200 |
| NPI Number | 1861560815 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 03/31/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861560815 | NPI | - | NPPES |
| 3164063 | Other | TN | BCBS OF TN IDENTIFER |
| 543902 | Other | TN | UNITED CONCORIDA NUMBER |
| 7505 | Other | TN | DOCTORS STATE LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7505 (Tennessee) | Secondary |
| 1223G0001X | Dentist - General Practice | 8672 (Tennessee) | Primary |
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