# CLARKSVILLE ORAL AND FACIAL SURGERY, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Clarksville Oral and Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073748042
- **Authorized official:** JASON SCOTT LILLY DMD (OWNER)
- **Authorized official phone:** (931) 552-7575

## Contact information

- **Practice address:** 1718 MEMORIAL DR, CLARKSVILLE, TN 37043-4542
- **Practice address phone:** (931) 552-4935
- **Practice address fax:** (931) 552-0959
- **Mailing address:** 1718 MEMORIAL DR, CLARKSVILLE, TN 37043-4542
- **Mailing address phone:** (931) 552-4935
- **Mailing address fax:** (931) 552-0959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4003 | TN | Yes |

## Other

- **Enumeration date:** 05/20/2009
- **Last updated:** 06/15/2016