| Back To Basics Dental Center, Llc | |
|
1762 Highway 48 Ste A Clarksville TN 37040-7284 | |
| (931) 645-8000 | |
| Not Available |
| Full Name | Back To Basics Dental Center, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1762 Highway 48, Clarksville, Tennessee |
| Authorized Official Name and Position | Jennifer Cornell (OWNER) |
| Authorized Official Contact | 9316458000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Back To Basics Dental Center, Llc 1762 Highway 48 Ste A Clarksville TN 37040-7284 Ph: () - | Back To Basics Dental Center, Llc 1762 Highway 48 Ste A Clarksville TN 37040-7284 Ph: (931) 645-8000 |
| NPI Number | 1013288257 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 09/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013288257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8416 (Tennessee) | Primary |
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