# BARTLETT DENTAL CLINIC II LLC

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

## Provider details

- **NPI number:** 1891823084
- **Authorized official:** JAMES DOUGLAS THOMAS (PRESIDENT)
- **Authorized official phone:** (901) 377-5060

## Contact information

- **Practice address:** 6630 SUMMER KNOLL CIRCLE, \#103, BARTLETT, TN 38134
- **Practice address phone:** (901) 377-5060
- **Practice address fax:** (901) 388-0040
- **Mailing address:** 6630 SUMMER KNOLL CIRCLE, \#103, BARTLETT, TN 38134
- **Mailing address phone:** (901) 377-5060
- **Mailing address fax:** (901) 388-0040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2880 | TN | — |
| 1223G0001X | General Practice Dentistry | 4386 | TN | Yes |

## Other

- **Enumeration date:** 03/01/2007
- **Last updated:** 08/17/2011