Organization
ALPHA DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW PALOMAKI DDS (OWNER)
(931) 431-0200
Entity
Organization
Contact information
Practice address
2485 FORT CAMPBELL BLVD, STE 101, CLARKSVILLE, TN 37042
(931) 431-0200
(931) 431-3022
Mailing address
2485 FORT CAMPBELL BLVD, STE 101, CLARKSVILLE, TN 37042
(931) 431-0200
(931) 431-3022
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7505
TN
1223G0001X
General Practice Dentistry
Primary
8672
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3164063
BCBS OF TN IDENTIFER
TN
01
—
543902
UNITED CONCORIDA NUMBER
TN
01
—
7505
DOCTORS STATE LICENSE #
TN
Enumeration date
11/30/2006
Last updated
03/31/2016
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