Organization
STATE OF TENNESSEE
Active
Other names
West Tennessee Regional Office Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN BARNES (REGIONAL DIRECTOR)
(731) 421-6700
Entity
Organization
Contact information
Practice address
295 SUMMAR DR, JACKSON, TN 38301-3905
(731) 421-6700
(731) 935-7093
Mailing address
295 SUMMAR DR, JACKSON, TN 38301-3905
(731) 421-6700
(731) 935-7093
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
08/18/2010
Last updated
08/20/2010
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