Healthcare Provider Details

I. General information

NPI: 1457057903
Provider Name (Legal Business Name): TW PRACTICE PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 COOK ST
DYERSBURG TN
38024-1882
US

IV. Provider business mailing address

1911 COOK ST
DYERSBURG TN
38024-1882
US

V. Phone/Fax

Practice location:
  • Phone: 731-286-0053
  • Fax:
Mailing address:
  • Phone: 731-286-0053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HILLARY HARRIS
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 912-270-0920