Organization
CRYSTAL CLEAR FAMILY DENTISTRY
Active
Other names
Crystal Clear Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH MEKONNEN DDS (CEO/OWNER)
(615) 584-3861
Entity
Organization
Contact information
Practice address
1210 HAZELWOOD DR STE A, SMYRNA, TN 37167-3964
(615) 930-2050
(615) 459-0568
Mailing address
415 AVONDALE DR, NASHVILLE, TN 37206-1818
(615) 584-3861
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437897907
—
TN
Enumeration date
08/28/2023
Last updated
08/28/2023
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