Healthcare Provider Details

I. General information

NPI: 1811700560
Provider Name (Legal Business Name): COLUMBIA DENTAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 HATCHER LN
COLUMBIA TN
38401-4825
US

IV. Provider business mailing address

1514 HATCHER LN
COLUMBIA TN
38401-4825
US

V. Phone/Fax

Practice location:
  • Phone: 931-201-3291
  • Fax: 931-381-7522
Mailing address:
  • Phone: 931-201-3291
  • Fax: 931-381-7522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH LYNN CLAYTON
Title or Position: DOCTOR/OWNER
Credential: DMD
Phone: 931-381-7591