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MRS. THERESA ANN GREEN RDA

Dental Assistant

Clarksville, Tennessee

Provider NPI: 1629269931

Provider Information:
MRS. THERESA ANN GREEN RDA
Gender: F
Not Sole Proprietor

Practice Location:
1573 FORT CAMPBELL BLVD  CLARKSVILLE, TN 37042 US
Tel: 931-553-0919  Fax: 931-553-0971

Business Mailing Address:
P.O. BOX 2339  CLARKSVILLE, TN 37042 US
Tel: 931-553-0919  Fax: 931-553-0971

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y126800000XDental Providers
Dental Assistant
TNDA0000010736





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