# CREATIVE SMILES FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013190149
- **Authorized official:** DR. WARREN FRED STOVALL DDS (DENTIST/ OWNER)
- **Authorized official phone:** (731) 665-7240

## Contact information

- **Practice address:** 608 S TRENTON ST, RUTHERFORD, TN 38369-9715
- **Practice address phone:** (731) 665-7240
- **Practice address fax:** (731) 665-7268
- **Mailing address:** PO BOX 38, 608 S. TRENTON ST, RUTHERFORD, TN 38369-0038
- **Mailing address phone:** (731) 665-7240
- **Mailing address fax:** (731) 665-7268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 7612 | TN | Yes |

## Other

- **Enumeration date:** 12/12/2007
- **Last updated:** 12/12/2007