Back to Basics Dental Center, LLC
NPI #1013288257 in Clarksville, Tennessee
Provider Information
- NPI Number
- 1013288257
- Entity Type
- Organization
- Organization Name
- Back to Basics Dental Center, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 19, 2012
- Last Updated
- Sep 16, 2015
Practice Location
- Address
- 1762 HIGHWAY 48
- Address 2
- STE A
- City
- Clarksville
- State
- Tennessee
- ZIP Code
- 37040-7284
- Phone
- (931) 645-8000
Authorized Official
- Name
- JENNIFER CORNELL, DDS
- Title
- OWNER
- Phone
- (931) 645-8000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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