Organization
CLARKSVILLE ORAL AND FACIAL SURGERY, PLLC
Active
Other names
Clarksville Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JASON SCOTT LILLY DMD (OWNER)
(931) 552-7575
Entity
Organization
Contact information
Practice address
1718 MEMORIAL DR, CLARKSVILLE, TN 37043-4542
(931) 552-4935
(931) 552-0959
Mailing address
1718 MEMORIAL DR, CLARKSVILLE, TN 37043-4542
(931) 552-4935
(931) 552-0959
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4003
TN
Other
Enumeration date
05/20/2009
Last updated
06/15/2016
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