Organization
CLARKSVILLE DENTAL SPA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANCE H HARRISON JR. DDS (DENTIST/OWNER)
(931) 647-8437
Entity
Organization
Contact information
Practice address
800 WEATHERLY DR, STE. 103-B, CLARKSVILLE, TN 37043-8957
(931) 647-8437
(931) 647-8439
Mailing address
800 WEATHERLY DR, STE. 103-B, CLARKSVILLE, TN 37043-8957
(931) 647-8437
(931) 647-8439
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8737
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5442012
—
TN
Enumeration date
11/04/2011
Last updated
08/29/2013
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