Provider Demographics
NPI:1851767727
Name:ANDERSON COUNTY DENTAL CLINIC
Entity Type:Organization
Organization Name:ANDERSON COUNTY DENTAL CLINIC
Other - Org Name:ANDERSON COUNTY GOVERNMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:LANGLEY
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-425-8820
Mailing Address - Street 1:710 N MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-3143
Mailing Address - Country:US
Mailing Address - Phone:865-425-8803
Mailing Address - Fax:
Practice Address - Street 1:710 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-3143
Practice Address - Country:US
Practice Address - Phone:865-425-8803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental