Organization
TINY TOWN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN FOSTER (PRACTICE ADMINISTRATOR)
(615) 498-4323
Entity
Organization
Contact information
Practice address
3402 CAINLO DR STE 100, CLARKSVILLE, TN 37042-0863
(931) 920-0440
(931) 920-0434
Mailing address
3402 CAINLO DR STE 100, CLARKSVILLE, TN 37042-0863
(931) 920-0440
(931) 920-0434
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8552
TN
Other
Enumeration date
01/17/2011
Last updated
01/17/2011
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