# PREMIER DENTAL CENTER

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

## Provider details

- **NPI number:** 1619239837
- **Authorized official:** MRS. MELISSA S. KIRK (SECRETARY)
- **Authorized official phone:** (731) 772-4567

## Contact information

- **Practice address:** 1203 E COLLEGE ST, BROWNSVILLE, TN 38012-1656
- **Practice address phone:** (731) 772-4567
- **Practice address fax:** (731) 772-6679
- **Mailing address:** 1203 E COLLEGE ST, BROWNSVILLE, TN 38012-1656
- **Mailing address phone:** (731) 772-4567
- **Mailing address fax:** (731) 772-6679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS3413 | TN | — |
| 1223G0001X | General Practice Dentistry | DS3682 | TN | Yes |
| 1223G0001X | General Practice Dentistry | DS7790 | TN | — |
| 1223G0001X | General Practice Dentistry | DS8401 | TN | — |

## Other

- **Enumeration date:** 06/13/2012
- **Last updated:** 06/13/2012