Provider Demographics
NPI:1003936436
Name:PITTENGER, DALE BRANDON (DDS)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:BRANDON
Last Name:PITTENGER
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 1:7443 OAK RIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-3428
Mailing Address - Country:US
Mailing Address - Phone:865-691-8166
Mailing Address - Fax:865-691-8166
Practice Address - Street 1:7443 OAK RIDGE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-3428
Practice Address - Country:US
Practice Address - Phone:865-691-8166
Practice Address - Fax:865-691-8166
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN70731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice