Provider Demographics
NPI:1457524175
Name:CRESSMAN, CLARK EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:CLARK
Middle Name:EUGENE
Last Name:CRESSMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2343
Mailing Address - Country:US
Mailing Address - Phone:931-588-3199
Mailing Address - Fax:
Practice Address - Street 1:1513 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2343
Practice Address - Country:US
Practice Address - Phone:931-588-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44301122300000X
NV4938T122300000X
AZD5620122300000X
NV49381223G0001X, 122300000X
TX386821223G0001X
IL0190347061223G0001X
TN118841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist