Centerville Dental
Organization Active NPI General Practice Dentistry · Centerville, TN
NPI 1174881965 · NPPES record last updated Apr 30, 2012
Key facts
- NPI
- 1174881965
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 8074 (TN)
- Legal business name
- CENTERVILLE DENTAL
- Practice address
- 704 Highway 100
Ste 101
Centerville, TN 37033-1171 - Phone
- (931) 729-2664
- Fax
- (931) 729-2666
- NPI assigned
- Apr 30, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Jamie M Lee, DDS
- Title
- Owner
- Phone
- (931) 729-2664
National Provider Directory
Locations
704 Highway 100
Ste 101
Centerville, TN 37033
Phone (931) 729-3573
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 8074 | TN | Yes |
Addresses
Primary practice location
704 Highway 100
Ste 101
Centerville, TN 37033-1171
Mailing address
704 Highway 100
Ste 101
Centerville, TN 37033-1171
Phone (931) 729-2664
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5441233 | Medicaid | TN |
Other providers in Centerville, TN
- Stephen Britt
- Carol J. Ballard OD
- Joseph Catlin
- Centerstone
- Centerstone
- Centerville Medical Investors, LLC
- Samantha Lea Claud
- Jennifer H Coates
- Cassie Laurel Coleman
- Stephanie Renee Collins
All providers in Centerville, TN · General Practice Dentistry in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.