Provider Demographics
NPI:1386930311
Name:POFF, CLAIR S (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAIR
Middle Name:S
Last Name:POFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MAPLE ROW BLVD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3853
Mailing Address - Country:US
Mailing Address - Phone:615-822-5588
Mailing Address - Fax:615-822-3206
Practice Address - Street 1:107 MAPLE ROW BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3853
Practice Address - Country:US
Practice Address - Phone:615-822-5588
Practice Address - Fax:615-822-3206
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN93311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525145Medicaid