Individual
KELLEY MARIE JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1466 TINY TOWN RD STE A, CLARKSVILLE, TN 37042-8292
(931) 548-0119
Mailing address
1217 CHINOOK CIR, CLARKSVILLE, TN 37042-8233
(217) 313-1071
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11094
TN
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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