Organization
TENNESSEE DENTAL PROFESSIONALS, PC
Active
Parent organization
TENNESSEE DENTAL PROFESSIONALS, PC
Other names
Johns Family & Implant Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
TENNESSEE DENTAL PROFESSIONALS, PC
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
121 S WASHINGTON AVE, COOKEVILLE, TN 38501-3547
(931) 400-5360
Mailing address
121 S WASHINGTON AVE, COOKEVILLE, TN 38501-3547
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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