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Organization

PREMIER DENTAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MELISSA S. KIRK (SECRETARY)
(731) 772-4567
Entity
Organization

Contact information

Practice address
1203 E COLLEGE ST, BROWNSVILLE, TN 38012-1656
(731) 772-4567
(731) 772-6679
Mailing address
1203 E COLLEGE ST, BROWNSVILLE, TN 38012-1656
(731) 772-4567
(731) 772-6679

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS3413
TN
1223G0001X
General Practice Dentistry
Primary
DS3682
TN
1223G0001X
General Practice Dentistry
DS7790
TN
1223G0001X
General Practice Dentistry
DS8401
TN

Other

Enumeration date
06/13/2012
Last updated
06/13/2012
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