# TOTAL DENTAL CENTER

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

## Provider details

- **NPI number:** 1528239589
- **Authorized official:** MRS. LYNORA JANE SINES BS, RN, MPH (MANAGER)
- **Authorized official phone:** (423) 338-7777

## Contact information

- **Practice address:** 108 LIFESTYLE WAY, BENTON, TN 37307-3914
- **Practice address phone:** (423) 338-7777
- **Practice address fax:** (423) 338-9326
- **Mailing address:** 108 LIFESTYLE WAY, BENTON, TN 37307-3914
- **Mailing address phone:** (423) 338-7777
- **Mailing address fax:** (423) 338-9326

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2526 | TN | Yes |

## Other

- **Enumeration date:** 03/18/2008
- **Last updated:** 03/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 108283 | DORAL TENNCARE | TN |