| Liberty Oral And Facial Surgery | |
|
535 Bell Trace Ct Clarksville TN 37040 | |
| (931) 999-7100 | |
| (931) 999-7101 |
| Full Name | Liberty Oral And Facial Surgery |
|---|---|
| Speciality | Dentist |
| Location | 535 Bell Trace Ct, Clarksville, Tennessee |
| Authorized Official Name and Position | Michael J Mcnaught (OWNER) |
| Authorized Official Contact | 9319997100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Oral And Facial Surgery 535 Bell Trace Ct Clarksville TN 37040 Ph: (931) 999-7100 | Liberty Oral And Facial Surgery 535 Bell Trace Ct Clarksville TN 37040 Ph: (931) 999-7100 |
| NPI Number | 1548834963 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Medicare PECOS PAC ID | 6608268784 |
|---|---|
| Medicare Enrollment ID | O20220124000099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548834963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Michael J Mcnaught |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1124222435 PECOS PAC ID: 2961623897 Enrollment ID: I20220124000154 |
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