NPI Code Details Logo

NPI 1972428274

NPI 1972428274 : VOLUNTEER DENTAL LLC : CLARKSVILLE, TN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1972428274
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    VOLUNTEER DENTAL LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/13/2026
-----------------------------------------------------
    Last Update Date     |    08/13/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1722 MEMORIAL DR 
-----------------------------------------------------
    City                 |    CLARKSVILLE
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37043-4542
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    931-645-2749
-----------------------------------------------------
    Fax                  |    931-645-2778
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1722 MEMORIAL DR 
-----------------------------------------------------
    City                 |    CLARKSVILLE
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37043-4542
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    931-645-2749
-----------------------------------------------------
    Fax                  |    931-645-2778
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER/DENTIST
-----------------------------------------------------
    Name                 |     JAYSEN  YARBROUGH 
-----------------------------------------------------
    Credential           |    DDS
-----------------------------------------------------
    Telephone            |    931-645-2749
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1223G0001X
-----------------------------------------------------
    Taxonomy Name        |    General Practice Dentistry
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.