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1692 Fort Campbell Blvd Clarksville TN 37042-7531 | |
| (931) 552-7745 | |
| (931) 645-3545 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1692 Fort Campbell Blvd, Clarksville, Tennessee |
| Authorized Official Name and Position | Madeline Hoesten (VP OFI INTEGRATON) |
| Authorized Official Contact | 5496753088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1692 Fort Campbell Blvd Clarksville TN 37042-7531 Ph: (931) 552-7745 | 1692 Fort Campbell Blvd Clarksville TN 37042-7531 Ph: (931) 552-7745 |
| NPI Number | 1770128977 |
|---|---|
| Provider Enumeration Date | 11/12/2019 |
| Last Update Date | 12/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770128977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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