| 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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