| Bivens Dental Group Pc | |
|
5103 Highway 100 Lyles TN 37098-1879 | |
| (931) 670-5961 | |
| Not Available |
| Full Name | Bivens Dental Group Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5103 Highway 100, Lyles, Tennessee |
| Authorized Official Name and Position | Darryl A Bivens (DENTIST) |
| Authorized Official Contact | 9316705961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bivens Dental Group Pc 5103 Highway 100 Lyles TN 37098-1879 Ph: (931) 670-5961 | Bivens Dental Group Pc 5103 Highway 100 Lyles TN 37098-1879 Ph: (931) 670-5961 |
| NPI Number | 1871747832 |
|---|---|
| Provider Enumeration Date | 11/04/2008 |
| Last Update Date | 11/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871747832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6858 (Tennessee) | Primary |
Perry County Medical Center, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7723 Clearview Church Ln Ste 200, Lyles, TN 37098 Phone: 931-670-8318 |