Provider First Line Business Practice Location Address:
BACK TO BASICS DENTAL CENTER
Provider Second Line Business Practice Location Address:
1762 TN HIGHWAY 48
Provider Business Practice Location Address City Name:
CLARKSVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-645-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2006