# RENFROE FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Derek Renfroe, DMD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104310895
- **Authorized official:** MRS. JORDAN DAVIS (OFFICE MANAGER)
- **Authorized official phone:** (931) 232-7105

## Contact information

- **Practice address:** 311 SPRING ST, DOVER, TN 37058-3227
- **Practice address phone:** (931) 232-7105
- **Practice address fax:** (931) 232-2242
- **Mailing address:** PO BOX 538, DOVER, TN 37058-0538
- **Mailing address phone:** (931) 232-7105
- **Mailing address fax:** (931) 232-2242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 9114 | TN | Yes |

## Other

- **Enumeration date:** 06/18/2018
- **Last updated:** 06/18/2018