Provider Demographics
NPI:1295991016
Name:OAKS, HAROLD CLIFFORD JR (DDS)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:CLIFFORD
Last Name:OAKS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BUTCH
Other - Middle Name:
Other - Last Name:OAKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:501 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-3027
Mailing Address - Country:US
Mailing Address - Phone:865-457-8636
Mailing Address - Fax:865-457-8967
Practice Address - Street 1:501 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-3027
Practice Address - Country:US
Practice Address - Phone:865-457-8636
Practice Address - Fax:865-457-8967
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0050211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice