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Organization
STATE OF TENNESSEE
Active
Organization
STATE OF TENNESSEE
Active
Other names
Robertson County Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE HALEY (REGIONAL DIRECTOR)
(615) 650-7000
Entity
Organization
Contact information
Practice address
806 SOUTH BROWN STREET, SPRINGFIELD, TN 37172
(615) 384-4504
(615) 384-2067
Mailing address
806 SOUTH BROWN STREET, SPRINGFIELD, TN 37172
(615) 384-4504
(615) 384-2067
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
NULL
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
09/09/2010
Last updated
08/28/2012
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