# STATE OF TENNESSEE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Robertson County Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861709024
- **Authorized official:** MRS. ANNETTE HALEY (REGIONAL DIRECTOR)
- **Authorized official phone:** (615) 650-7000

## Contact information

- **Practice address:** 806 SOUTH BROWN STREET, SPRINGFIELD, TN 37172
- **Practice address phone:** (615) 384-4504
- **Practice address fax:** (615) 384-2067
- **Mailing address:** 806 SOUTH BROWN STREET, SPRINGFIELD, TN 37172
- **Mailing address phone:** (615) 384-4504
- **Mailing address fax:** (615) 384-2067

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2010
- **Last updated:** 08/28/2012