# TENNESSEE DENTAL PROFESSIONALS, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TENNESSEE DENTAL PROFESSIONALS, PC
- **Other names:** Johns Family & Implant Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376009977
- **Legal business name:** TENNESSEE DENTAL PROFESSIONALS, PC
- **Authorized official:** TABATHA LEMKE (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-6078

## Contact information

- **Practice address:** 121 S WASHINGTON AVE, COOKEVILLE, TN 38501-3547
- **Practice address phone:** (931) 400-5360
- **Mailing address:** 121 S WASHINGTON AVE, COOKEVILLE, TN 38501-3547

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/19/2019
- **Last updated:** 02/19/2019