| Clarksville Dental Center- St B | |
|
1715 Wilma Rudolph Blvd Suite A Clarksville TN 37040-6861 | |
| (931) 645-2469 | |
| (931) 551-9954 |
| Full Name | Clarksville Dental Center- St B |
|---|---|
| Speciality | Dentist |
| Location | 1715 Wilma Rudolph Blvd, Clarksville, Tennessee |
| Authorized Official Name and Position | Stan Montee (OWNER/DENTIST) |
| Authorized Official Contact | 9316459469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksville Dental Center- St B 1715 Wilma Rudolph Blvd Suite A Clarksville TN 37040-6861 Ph: (931) 645-2469 | Clarksville Dental Center- St B 1715 Wilma Rudolph Blvd Suite A Clarksville TN 37040-6861 Ph: (931) 645-2469 |
| NPI Number | 1346588282 |
|---|---|
| Provider Enumeration Date | 01/28/2013 |
| Last Update Date | 01/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346588282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8290 (Tennessee) | Primary |
| 122300000X | Dentist | 9114 (Tennessee) | Secondary |
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