Provider Demographics
NPI:1871509125
Name:RANKIN, OSCAR LANE JR (D D S)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:LANE
Last Name:RANKIN
Suffix:JR
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3425
Mailing Address - Street 2:1756 MEMORIAL DRIVE
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-3425
Mailing Address - Country:US
Mailing Address - Phone:931-648-3450
Mailing Address - Fax:931-648-2837
Practice Address - Street 1:1756 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4562
Practice Address - Country:US
Practice Address - Phone:931-648-3450
Practice Address - Fax:931-648-2837
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-3112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist