| Clarksville Dental Spa, Pllc | |
|
800 Weatherly Dr Ste. 103-b Clarksville TN 37043-8957 | |
| (931) 647-8437 | |
| (931) 647-8439 |
| Full Name | Clarksville Dental Spa, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 800 Weatherly Dr, Clarksville, Tennessee |
| Authorized Official Name and Position | Lance H Harrison (DENTIST/OWNER) |
| Authorized Official Contact | 9316478437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksville Dental Spa, Pllc 800 Weatherly Dr Ste. 103-b Clarksville TN 37043-8957 Ph: (931) 647-8437 | Clarksville Dental Spa, Pllc 800 Weatherly Dr Ste. 103-b Clarksville TN 37043-8957 Ph: (931) 647-8437 |
| NPI Number | 1467739441 |
|---|---|
| Provider Enumeration Date | 11/04/2011 |
| Last Update Date | 08/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467739441 | NPI | - | NPPES |
| 5442012 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8737 (Tennessee) | Primary |
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