Organization
RENFROE FAMILY DENTAL
Active
Other names
Derek Renfroe, DMD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JORDAN DAVIS (OFFICE MANAGER)
(931) 232-7105
Entity
Organization
Contact information
Practice address
311 SPRING ST, DOVER, TN 37058-3227
(931) 232-7105
(931) 232-2242
Mailing address
PO BOX 538, DOVER, TN 37058-0538
(931) 232-7105
(931) 232-2242
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9114
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4274444
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
Enumeration date
06/18/2018
Last updated
06/18/2018
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